Manuela Costantini1, Maria Luana Poeta2, Ruth M Pfeiffer3, Dana Hashim4, Catherine L Callahan3, Steno Sentinelli5, Laura Mendoza3, Marco Vicari6, Vincenzo Pompeo1, Angela Cecilia Pesatori7, Curt T DellaValle3, Giuseppe Simone1, Vito Michele Fazio8, Michele Gallucci9, Maria Teresa Landi10. 1. Department of Urology, IRCCS- Regina Elena National Cancer Institute, Rome, Italy. 2. Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Italy. 3. Division of Cancer Epidemiology Genetics, National Cancer Institute, NIH, Bethesda, MD. 4. Department of Hematology and Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY. 5. Department of Pathology, IRCCS- Regina Elena National Cancer Institute, Rome, Italy. 6. Laboratory of Molecular Medicine and Biotechnology, University Campus Bio-Medico of Rome, Italy. 7. Department of Clinical Sciences and Community Health, Università degli Studi di Milano and Fondazione IRCCS - Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 8. Laboratory of Molecular Medicine and Biotechnology, University Campus Bio-Medico of Rome, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano and Fondazione IRCCS - Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Laboratory of Oncology, IRCCS H. "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy. 9. Department of Urology, IRCCS- Regina Elena National Cancer Institute, Rome, Italy; Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Italy; Division of Cancer Epidemiology Genetics, National Cancer Institute, NIH, Bethesda, MD; Department of Hematology and Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Pathology, IRCCS- Regina Elena National Cancer Institute, Rome, Italy; Laboratory of Molecular Medicine and Biotechnology, University Campus Bio-Medico of Rome, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano and Fondazione IRCCS - Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Laboratory of Oncology, IRCCS H. "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy; Department of Urology, Sapienza University, Rome, Italy. 10. Division of Cancer Epidemiology Genetics, National Cancer Institute, NIH, Bethesda, MD. Electronic address: landim@mail.nih.gov.
Abstract
INTRODUCTION: The optimal length for clinical follow-up of renal cell carcinoma (RCC) patients is unclear. We evaluated the impact of ISUP/WHO tumor grade and histological subtype on short- and long-term survival and risk of recurrence/metastasis in a large cohort of RCC patients. PATIENTS AND METHODS: We studied 1679 RCC patients from a single referral center in Italy. Adjusted hazard ratios for overall survival were estimated using Cox regression models. Adjusted absolute risk of developing recurrence or metastasis was computed considering competing risks of mortality. RESULTS: During up to 13 years of follow-up, 175 (10.4%) RCC patients died, of whom 92% beyond 5 years. Hazard ratio of grade IV clear cell carcinomas (ccRCC) was 3.82 compared to grade II. Notably, 33% of recurrences and 56% of distant metastases occurred beyond 5 years of follow-up. The estimated probabilities of recurrence/metastasis were 15% and 45% within and beyond 5 years of follow-up, respectively. After 5 years, the absolute risk of recurrences increased also for papillary renal cell carcinoma type I (35.2%) and grade I ccRCC (17%). CONCLUSION: After 5 years of follow-up, both risk of mortality and recurrences or metastases were high and were modified by histological types and tumor grade. These data strongly support histology- and grade-tailored surveillance strategies and long-term follow-up for RCC patients.
INTRODUCTION: The optimal length for clinical follow-up of renal cell carcinoma (RCC) patients is unclear. We evaluated the impact of ISUP/WHO tumor grade and histological subtype on short- and long-term survival and risk of recurrence/metastasis in a large cohort of RCC patients. PATIENTS AND METHODS: We studied 1679 RCC patients from a single referral center in Italy. Adjusted hazard ratios for overall survival were estimated using Cox regression models. Adjusted absolute risk of developing recurrence or metastasis was computed considering competing risks of mortality. RESULTS: During up to 13 years of follow-up, 175 (10.4%) RCC patients died, of whom 92% beyond 5 years. Hazard ratio of grade IV clear cell carcinomas (ccRCC) was 3.82 compared to grade II. Notably, 33% of recurrences and 56% of distant metastases occurred beyond 5 years of follow-up. The estimated probabilities of recurrence/metastasis were 15% and 45% within and beyond 5 years of follow-up, respectively. After 5 years, the absolute risk of recurrences increased also for papillary renal cell carcinoma type I (35.2%) and grade I ccRCC (17%). CONCLUSION: After 5 years of follow-up, both risk of mortality and recurrences or metastases were high and were modified by histological types and tumor grade. These data strongly support histology- and grade-tailored surveillance strategies and long-term follow-up for RCC patients.
Authors: Börje Ljungberg; Laurance Albiges; Yasmin Abu-Ghanem; Karim Bensalah; Saeed Dabestani; Sergio Fernández-Pello; Rachel H Giles; Fabian Hofmann; Milan Hora; Markus A Kuczyk; Teele Kuusk; Thomas B Lam; Lorenzo Marconi; Axel S Merseburger; Thomas Powles; Michael Staehler; Rana Tahbaz; Alessandro Volpe; Axel Bex Journal: Eur Urol Date: 2019-02-23 Impact factor: 20.096
Authors: William R Sukov; Christine M Lohse; Bradley C Leibovich; R Houston Thompson; John C Cheville Journal: J Urol Date: 2011-11-16 Impact factor: 7.450
Authors: Sabine Brookman-May; Matthias May; Shahrokh F Shariat; Evanguelos Xylinas; Christian Stief; Richard Zigeuner; Thomas Chromecki; Maximilian Burger; Wolf F Wieland; Luca Cindolo; Luigi Schips; Ottavio De Cobelli; Bernardo Rocco; Cosimo De Nunzio; Bogdan Feciche; Michael Truss; Christian Gilfrich; Sascha Pahernik; Markus Hohenfellner; Stefan Zastrow; Manfred P Wirth; Giacomo Novara; Marco Carini; Andrea Minervini; Claudio Simeone; Alessandro Antonelli; Vincenzo Mirone; Nicola Longo; Alchiede Simonato; Giorgio Carmignani; Vincenzo Ficarra Journal: Eur Urol Date: 2012-06-22 Impact factor: 20.096