{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T04:07:46Z","timestamp":1761624466596,"version":"build-2065373602"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>A clear understanding of the risk of clear cell renal cell carcinoma (ccRCC) recurrence in individual patients is essential for appropriate administration of adjuvant therapy. Notably, non\u2010metastatic pT3a ccRCCs are heterogeneous, and affected patients will have a different prognosis depending on the pathological definition. The present study was conducted to identify factors associated with postoperative recurrence in pT3a ccRCC cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 295 patients who underwent a radical or partial nephrectomy for RCC at our institution from 2013 to 2022 and identified 42 with pT3aN0M0 ccRCC. Preoperative clinical and pathological data, including blood parameters, were collected, and their association with recurrence\u2010free survival (RFS) was evaluated. The Kaplan\u2013Meier method and uni\u2010 and multivariable Cox proportional hazard regression were used for statistical analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Univariate and subsequent multivariate analyses showed white blood cells, platelets, and mixed patterns of pT3a components as independent prognostic factors with significant relationships with RFS. Kaplan\u2013Meier curves revealed that the presence of leukocytosis or thrombocytosis was associated with worse RFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001, respectively), while patients with a mixed pattern of pT3a components also had worse RFS as compared to those with a single pattern (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0007). Furthermore, accuracy for prediction of RFS in pT3a ccRCC cases was improved by classification based on the number of retained factors, that is, leukocytosis, thrombocytosis, and mixed patterns of pT3a components.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The present findings indicate that inflammatory markers, such as leukocytes and platelets, as well as multiple patterns of extrarenal extension are factors useful for predicting RFS in patients with pT3aN0M0 ccRCC. Their combined use should aid in the selection of appropriate postoperative adjuvant therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70371","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T12:40:14Z","timestamp":1760791214000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Inflammatory Markers in Combination With Multiple Patterns of Extrarenal Extension Accurately Indicate Recurrence Risk in Patients With\n                    <scp>pT3aN0M0<\/scp>\n                    Clear Cell Renal Cell Carcinoma"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9032-9971","authenticated-orcid":false,"given":"Masato","family":"Uetani","sequence":"first","affiliation":[{"name":"Department of Urology Toho University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumito","family":"Yamabe","sequence":"additional","affiliation":[{"name":"Department of Urology Toho University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Hori","sequence":"additional","affiliation":[{"name":"Department of Urology Toho University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3124-8792","authenticated-orcid":false,"given":"Mizuki","family":"Kasahara","sequence":"additional","affiliation":[{"name":"Department of Urology Toho University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mizuho","family":"Okawa","sequence":"additional","affiliation":[{"name":"Department of Urology Toho University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1381-1665","authenticated-orcid":false,"given":"Hideyuki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology Toho University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Nagao","sequence":"additional","affiliation":[{"name":"Department of Urology Toho University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Urology Toho University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2919-0058","authenticated-orcid":false,"given":"Yozo","family":"Mitsui","sequence":"additional","affiliation":[{"name":"Department of Urology Toho University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21708"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g4797"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.02.039"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104\u2010016\u20101895\u20108"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2106391"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00487-9"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2008.10.017"},{"key":"e_1_2_10_9_1","first-page":"700","article-title":"An Optimal Follow\u2010Up Protocol for Renal Cell Carcinoma Based on the Occurrence of Recurrences After Surgery","volume":"91","author":"Muramoto 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Non\u2010Metastatic Renal Cell Carcinoma","volume":"35","author":"Hutterer G. C.","year":"2015","journal-title":"Anticancer Research"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2008.08236.x"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010018\u201032362\u2010w"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11123140"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1255727"},{"key":"e_1_2_10_25_1","first-page":"653","article-title":"Systemic Inflammatory Markers Predicting the Overall Survival of Patients Using Tyrosine Kinase Inhibitors in the First\u2010Line Treatment of Metastatic Renal Cell Carcinoma","volume":"33","author":"Korkmaz M.","year":"2023","journal-title":"Journal of the College of Physicians and Surgeons\u2013Pakistan"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.9282-21"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2018.03.002"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.844520"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)71222-7"}],"container-title":["Cancer Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.70371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T04:01:12Z","timestamp":1761624072000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cnr2.70371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":28,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/cnr2.70371"],"URL":"https:\/\/doi.org\/10.1002\/cnr2.70371","archive":["Portico"],"relation":{},"ISSN":["2573-8348","2573-8348"],"issn-type":[{"type":"print","value":"2573-8348"},{"type":"electronic","value":"2573-8348"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2024-01-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70371"}}