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Review
. 2012;17(1):46-54.
doi: 10.1634/theoncologist.2011-0227. Epub 2012 Jan 10.

Sarcomatoid renal cell carcinoma: a comprehensive review of the biology and current treatment strategies

Brian Shuch  1 , Gennady Bratslavsky, W Marston Linehan, Ramaprasad Srinivasan
Affiliations
Review

Sarcomatoid renal cell carcinoma: a comprehensive review of the biology and current treatment strategies

Brian Shuch et al. Oncologist. 2012.

Abstract

Recent advancements in the molecular characterization of renal cell carcinoma altered the classification system and now kidney cancer is divided into several distinct histologic subtypes. Although once a separate histologic category, sarcomatoid renal cell carcinoma is no longer considered a separate tumor type because it can occur with all histologic subtypes. Limited research on tumors with sarcomatoid change has led to minimal progress in the understanding and treatment of these tumors. Because the sarcomatoid variant of renal cell carcinoma can account for approximately one in six cases of advanced kidney cancer, we hope to familiarize clinicians with these tumors by describing the historic background, histologic features, molecular characterization, diagnosis, prognosis, treatment strategies, and active clinical trials of this aggressive type of tumor.

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Conflict of interest statement

Disclosures

Brian Shuch: None; Gennady Bratslavsky: None; W. Marston Linehan: None; Ramaprasad Srinivasan: None.

Section Editor Derek Raghavan: sanofi international (advisory board), Gerson Lehrman (C/A).

Reviewer “A”: Aveo (C/A); Pfizer, Bayer, Novartis (H); GlaxoSmithKline (RF, H).

Figures

Figure 1.
Figure 1.
Sarcomatoid renal tumor displaying elongated, spindle-shaped cells, high cellularity, and cellular atypia. This clear cell renal tumor had 70% sarcomatoid features and the patient presented with lung, nodal, and colon metastases.
Figure 2.
Figure 2.
Histogram demonstrating the wide variability in the percentage of sarcomatoid histology in the primary tumor in 104 patients with sarcomatoid renal cell carcinoma. Unpublished data from UCLA, used with permission from A. Belldegrun.
Figure 3.
Figure 3.
Kaplan–Meier analysis of overall survival in months after cytoreductive nephrectomy for sarcomatoid (red) and nonsarcomatoid renal cell carcinoma. Adapted from Shuch B, Said J, La Rochelle JC et al. Cytoreductive nephrectomy for kidney cancer with sarcomatoid histology–is up-front resection indicated and, if not, is it avoidable? J Urol 2009;182:2164–2171, with permission.
See this image and copyright information in PMC

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