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. 2009 Nov;182(5):2132-6.
doi: 10.1016/j.juro.2009.07.019. Epub 2009 Sep 16.

Prognostic impact of histological subtype on surgically treated localized renal cell carcinoma

Patrick E Teloken  1 , R Houston Thompson, Satish K Tickoo, Angel Cronin, Caroline Savage, Victor E Reuter, Paul Russo
Affiliations

Prognostic impact of histological subtype on surgically treated localized renal cell carcinoma

Patrick E Teloken et al. J Urol. 2009 Nov.

Abstract

Purpose: Despite the clear demonstration that different histological subtypes of renal cell carcinoma show distinct pathogenesis and genetic alterations, the impact of histology on prognosis remains controversial. We evaluated our experience with tumor histology in patients with localized renal cell carcinoma.

Materials and methods: We identified 1,863 patients with localized clear cell, papillary or chromophobe renal cell carcinoma who were treated surgically between 1989 and 2006 at our tertiary care center. Cox proportional hazards regression models were used to evaluate the relationship between tumor histology and outcome, defined as metastasis or death from disease, adjusting for age, sex, operation type, American Society of Anesthesiologists score, TNM stage and tumor size.

Results: Of 1,863 patients 1,333 (72%) had clear cell histology, and 310 (17%) and 220 (12%) had papillary and chromophobe renal cell carcinoma, respectively. Median followup in patients without an event was 3.4 years. On univariate analysis patients with clear cell histology had a worse clinical outcome. Five-year probability of freedom from metastasis or death from disease was 86% (95% CI 84, 88), 95% (95% CI 91, 97) and 92% (95% CI 85, 96) in patients with clear cell, papillary and chromophobe histology, respectively (p <0.001). On multivariate analysis chromophobe (HR 0.40; 95% CI 0.20, 0.80) and papillary (HR 0.62; 95% CI 0.34, 1.14) histology was also significantly associated with better outcome (p = 0.014).

Conclusions: Clear cell histology seems to be independently associated with worse outcomes in patients who undergo surgery for renal cell carcinoma even after controlling for widely accepted factors influencing prognosis.

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Figures

Figure 1
Figure 1
Kaplan-Meier curve for patients with kidney cancer, stratified by tumor histology: clear cell (solid line), papillary (short dash), chromophobe (long dash). Event-free survival was defined as the time from surgery to the earlier of metastasis or disease specific death
See this image and copyright information in PMC

Comment in

  • Editorial comment.
    Klatte T. Klatte T. J Urol. 2009 Nov;182(5):2136. doi: 10.1016/j.juro.2009.07.113. Epub 2009 Sep 16. J Urol. 2009. PMID: 19758634 No abstract available.

References

    1. Kovacs G, Akhtar M, Beckwith BJ, Bugert P, Cooper CS, Delahunt B, Eble JN, Fleming S, Ljungberg B, Medeiros LJ, Moch H, Reuter VE, Ritz E, Roos G, Schmidt D, Srigley JR, Storkel S, van den Berg E, Zbar B. The Heidelberg classification of renal cell tumours. J Pathol. 1997 Oct;183(2):131–3. - PubMed
    1. Reuter VE. The pathology of renal epithelial neoplasms. Semin Oncol. 2006 Oct;33(5):534–43. - PubMed
    1. Schuetz AN, Yin-Goen Q, Amin MB, Moreno CS, Cohen C, Hornsby CD, Yang WL, Petros JA, Issa MM, Pattaras JG, Ogan K, Marshall FF, Young AN. Molecular classification of renal tumors by gene expression profiling. J Mol Diagn. 2005 May;7(2):206–18. - PMC - PubMed
    1. Furge KA, Lucas KA, Takahashi M, Sugimura J, Kort EJ, Kanayama HO, Kagawa S, Hoekstra P, Curry J, Yang XJ, Teh BT. Robust classification of renal cell carcinoma based on gene expression data and predicted cytogenetic profiles. Cancer Res. 2004 Jun 15;64(12):4117–21. - PubMed
    1. Cohen HT, McGovern FJ. Renal-cell carcinoma. N Engl J Med. 2005 Dec 8;353(23):2477–90. - PubMed