Emily C L Wong1, Richard Di Lena1, Rodney H Breau2, Frederic Pouliot3, Antonio Finelli4, Luke T Lavallée2, Alan So5, Simon Tanguay6, Adrian Fairey7, Ricardo Rendon8, Patrick O Richard9, Jean-Baptiste Lattouf10, Jun Kawakami11, Ranjeeta Mallick12, Anil Kapoor13. 1. Department of Surgery, Division of Urology, Hamilton, Ontario. 2. Department of Surgery, Division of Urology, Ottawa, Ontario. 3. Department of Surgery, Division of Urology, Québec City, Québec. 4. Department of Surgery, Division of Urology, Toronto, Ontario. 5. Department of Surgery, Division of Urology, Vancouver, British Columbia. 6. Department of Surgery, Division of Urology, Montreal, Quebec. 7. Department of Surgery, Division of Urology, Edmonton, Alberta. 8. Department of Surgery, Division of Urology, Halifax, Nova Scotia. 9. Department of Surgery, Division of Urology, Sherbrooke, Québec. 10. Department of Surgery, Division of Urology, Montréal, Québec. 11. Department of Surgery, Division of Urology, Calgary, Alberta. 12. Ottawa Hospital Research Institute, Ottawa, Ontario. 13. Department of Surgery, Division of Urology, Hamilton, Ontario. Electronic address: akapoor@mcmaster.ca.
Abstract
OBJECTIVE: To evaluate outcomes of surgically treated patients with clinically localized papillary renal cell carcinoma (RCC) and determine if papillary RCC subtype is associated with recurrence and survival. METHODS: This is a historical cohort study using the prospectively maintained Canadian Kidney Cancer Information System database between January 2011 and September 2018. All patients underwent partial or radical nephrectomy. Patient, tumor, treatment, and outcomes were compared between papillary RCC type 2 and type 1 cohorts. RESULTS: During the study period, 509 patients had clinically localized papillary RCC type 2 (n = 172) or type 1 (n = 337) histology. Sex, race, and comorbidities were similar between groups. Pathologic stage (pT3 or pT4), nuclear grade (3 or 4), and tumor diameter were higher in the type 2 papillary RCC cohort (P < 0.0001). A greater proportion of type 2 papillary RCC patients received radical nephrectomy (42.4% vs. 24.6%, P< 0.0001). More type 2 papillary RCC patients underwent lymph node dissection (19.6% vs. 5.5%, P< 0.0001) and had lymph node metastases removed during surgery (6.4% vs. 0.6%, P= 0.103). Overall, adjusting for age, grade, pathologic stage, positive nodes, and tumor size, type 2 papillary RCC had worse outcomes compared to type 1, as demonstrated by elevated all-cause mortality (hazard ratio = 7.7 [95% confidence interval: 2.0-28.9]), P=0.0027) and worse recurrence-free survival (hazard ratio = 8.2 [95% confidence interval: 3.6-19.0], P< 0.0001). CONCLUSION: Patients with clinically localized type 2 papillary RCC present with higher risk disease and have worse prognosis compared to patients with clinically localized type 1 papillary RCC. To the best of our knowledge, this is the largest cohort study comparing papillary RCC subtypes.
OBJECTIVE: To evaluate outcomes of surgically treated patients with clinically localized papillary renal cell carcinoma (RCC) and determine if papillary RCC subtype is associated with recurrence and survival. METHODS: This is a historical cohort study using the prospectively maintained Canadian Kidney Cancer Information System database between January 2011 and September 2018. All patients underwent partial or radical nephrectomy. Patient, tumor, treatment, and outcomes were compared between papillary RCC type 2 and type 1 cohorts. RESULTS: During the study period, 509 patients had clinically localized papillary RCC type 2 (n = 172) or type 1 (n = 337) histology. Sex, race, and comorbidities were similar between groups. Pathologic stage (pT3 or pT4), nuclear grade (3 or 4), and tumor diameter were higher in the type 2 papillary RCC cohort (P < 0.0001). A greater proportion of type 2 papillary RCCpatients received radical nephrectomy (42.4% vs. 24.6%, P< 0.0001). More type 2 papillary RCCpatients underwent lymph node dissection (19.6% vs. 5.5%, P< 0.0001) and had lymph node metastases removed during surgery (6.4% vs. 0.6%, P= 0.103). Overall, adjusting for age, grade, pathologic stage, positive nodes, and tumor size, type 2 papillary RCC had worse outcomes compared to type 1, as demonstrated by elevated all-cause mortality (hazard ratio = 7.7 [95% confidence interval: 2.0-28.9]), P=0.0027) and worse recurrence-free survival (hazard ratio = 8.2 [95% confidence interval: 3.6-19.0], P< 0.0001). CONCLUSION:Patients with clinically localized type 2 papillary RCC present with higher risk disease and have worse prognosis compared to patients with clinically localized type 1 papillary RCC. To the best of our knowledge, this is the largest cohort study comparing papillary RCC subtypes.
Authors: Manuela Costantini; Maria Luana Poeta; Ruth M Pfeiffer; Dana Hashim; Catherine L Callahan; Steno Sentinelli; Laura Mendoza; Marco Vicari; Vincenzo Pompeo; Angela Cecilia Pesatori; Curt T DellaValle; Giuseppe Simone; Vito Michele Fazio; Michele Gallucci; Maria Teresa Landi Journal: Clin Genitourin Cancer Date: 2021-07-10 Impact factor: 3.121
Authors: Toni K Choueiri; Daniel Y C Heng; Jae Lyun Lee; Mathilde Cancel; Remy B Verheijen; Anders Mellemgaard; Lone H Ottesen; Melanie M Frigault; Anne L'Hernault; Zsolt Szijgyarto; Sabina Signoretti; Laurence Albiges Journal: JAMA Oncol Date: 2020-08-01 Impact factor: 31.777