Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Oct 21:9:922150.
doi: 10.3389/fsurg.2022.922150. eCollection 2022.

Clinicopathologic factors linked to oncologic outcomes for renal cell carcinoma with sarcomatoid dedifferentiation: A PRISMA-compliant systematic review and meta-analysis

Lisong Shan  1 , Xue Shao  2 , Liangyou Gu  3 , Minhong Wu  4 , Pengxiu Lin  4 , Zhiling Yu  4 , Qingsheng Chen  4 , Daqing Zhu  1
Affiliations
Review

Clinicopathologic factors linked to oncologic outcomes for renal cell carcinoma with sarcomatoid dedifferentiation: A PRISMA-compliant systematic review and meta-analysis

Lisong Shan et al. Front Surg. .

Abstract

Background: There are still differences in the prognostic factors of renal cell carcinoma with sarcomatoid dedifferentiation (sRCC). The aim of this study was to evaluate important predictors of survival in patients with sRCC.

Patients and methods: A comprehensive search of PubMed, Embase, and Cochrane Library was conducted to identify eligible studies. The endpoints embraced overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS). Hazard ratios (HRs) and related 95% confidence intervals (CIs) were extracted.

Results: A total of 13 studies were included for analyses. The pooled results showed that high European Cooperative Oncology Group performance score (HR 2.39, 95% CI 1.32-4.30; P = 0.004), high T stage (HR 2.18, 95% CI 1.66-2.86; P < 0.001), positive lymph node (HR 1.54, 95% CI 1.40-1.69; P < 0.001), distant metastasis (HR 2.52, 95% CI 1.99-3.21; P < 0.001), lung metastases (HR 1.45, 95% CI 1.16-1.80; P < 0.001), liver metastases (HR 1.71, 95% CI 1.30-2.25; P < 0.001), tumor necrosis (HR 1.78, 95% CI 1.14-2.80; P = 0.010), and percentage sarcomatoid ≥50% (HR 2.35, 95% CI 1.57-3.52; P < 0.001) were associated with unfavorable OS. Positive lymph node (HR 1.57, 95% CI 1.33-1.85; P < 0.001) and high neutrophil to lymphocyte ratio (HR 1.16, 95% CI 1.04-1.29; P = 0.008) were associated with unfavorable CSS. High T stage (HR 1.93 95% CI 1.44-2.58; P < 0.001) was associated with unfavorable progression-free survival.

Conclusions: A meta-analysis of available data identified important prognostic factors for CSS, OS, and PFS of sRCC, which should be systematically evaluated for patient counseling, risk stratification, and treatment selection.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=249449.

Keywords: meta-analysis; prognosis; renal cell carcinoma; sarcomatoid differentiation; surgical oncology.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection process.
Figure 2
Figure 2
Forrest plots of meta-analyses of predictors of overall survival: (A) ECOG PS (≥1 vs 0); (B) T stage (3–4 vs 1–2); (C) positive lymph node; (D) distant metastasis; (E) lung metastases; (F) liver metastases. ECOG PS, European Cooperative Oncology Group performance score.
Figure 3
Figure 3
Forrest plots of meta-analyses of predictors of overall survival: (A) histology (non-clear cell vs clear cell); (B) microvascular invasion; (C) tumor necrosis; (D) percentage sarcomatoid (≥50% vs <50%).
Figure 4
Figure 4
Forrest plots of meta-analyses of predictors of cancer-specific survival and progression-free survival: (A) positive lymph node; (B) NLR; (C) T stage (3–4 vs 1–2). NLR, neutrophil to lymphocyte ratio.
Figure 5
Figure 5
Funnel plot for (A) T stage (3–4 vs 1–2) of OS; (B) positive lymph node of OS. Sensitivity analysis for (C) T stage (3–4 vs 1–2) of OS; (D) positive lymph node of OS. OS, overall survival.
See this image and copyright information in PMC

References

    1. Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M, et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. (2015) 67(5):913–24. 10.1016/j.eururo.2015.01.005 - DOI - PubMed
    1. Thomas AZ, Adibi M, Slack RS, Borregales LD, Merrill MM, Tamboli P, et al. The role of metastasectomy in patients with renal cell carcinoma with sarcomatoid dedifferentiation: a matched controlled analysis. J Urol. (2016) 196(3):678–84. 10.1016/j.juro.2016.03.144 - DOI - PMC - PubMed
    1. Shuch B, Bratslavsky G, Shih J, Vourganti S, Finley D, Castor B, et al. Impact of pathological tumour characteristics in patients with sarcomatoid renal cell carcinoma. BJU Int. (2012) 109(11):1600–6. 10.1111/j.1464-410X.2011.10785.x - DOI - PMC - PubMed
    1. Zhang BY, Thompson RH, Lohse CM, Leibovich BC, Boorjian SA, Cheville JC, et al. A novel prognostic model for patients with sarcomatoid renal cell carcinoma. BJU Int. (2015) 115(3):405–11. 10.1111/bju.12781 - DOI - PubMed
    1. Shuch B, Said J, La Rochelle JC, Zhou Y, Li G, Klatte T, 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(5):2164–71. 10.1016/j.juro.2009.07.049 - DOI - PMC - PubMed

LinkOut - more resources