Chromophobe Renal Cell Carcinoma: Results From a Large Single-Institution Series

Casuscelli, Jozefina; Becerra, Maria F.; Seier, Kenneth; Manley, Brandon J.; Benfante, Nicole; Redzematovic, Almedina; Stief, Christian G.; Hsieh, James J.; Tickoo, Satish K.; Reuter, Victor E.; Coleman, Jonathan A.; Russo, Paul; Ostrovnaya, Irina und Hakimi, A. Ari (2019): Chromophobe Renal Cell Carcinoma: Results From a Large Single-Institution Series. In: Clinical Genitourinary Cancer, Bd. 17, Nr. 5

Abstract

Chromophobe renal cell carcinoma is usually a relatively indolent form of kidney cancer with low risk of metastases. In our study we show that if initial kidney tumors present with large size, or with sarcomatoid features, closer follow-up is needed to identify and promptly treat patients with a higher risk of metastatic disease and subsequently a worse prognosis. Background: The purpose of the study was to evaluate clinical features and prognostic factors in a large single institutional cohort of chromophobe renal cell carcinoma (ChRCC) patients for identification of tumors with the highest metastatic potential. Patients and Methods: Clinicopathological parameters of all patients with ChRCC diagnosed and surgically treated at Memorial Sloan Kettering Cancer Center between 1990 and 2016 were identified and compared with patients treated for clear-cell renal cell carcinoma (ccRCC) in the same study period using Wilcoxon test for continuous variables and Fisher exact test for categorical variables. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan-Meier method, log rank test, and Cox proportional hazards regression. Results: Four hundred ninety-six patients with ChRCC (10-year RFS, 91.7% and OS, 82.1%) and 3312 patients with ccRCC (10-year RFS, 79.4% and OS, 63.6%) were included in the analysis. Patients with ChRCC were younger (median 59 vs. 61 years;P = .0015), less frequently male (54.8% vs. 66.3%;P < .0001), showed more favorable T stages (T1-2 in 78% vs. 67%;P < .0001) and less frequent sarcomatoid differentiation (1.2 % vs. 4%;P = .0008) and showed lower rates of metastatic development compared with ccRCC patients. Larger tumor size, sarcomatoid differentiation, and higher T-stage are significantly associated with adverse RFS and OS in chromophobe tumors. Conclusion: ChRCC is more commonly diagnosed in female and younger patients and is associated with a more favorable clinical outcome and a lower propensity for metastatic development than ccRCC. Larger tumors and sarcomatoid differentiation of ChRCC might be considered as risk factors for metastatic development.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1558-7673
• Sprache: Englisch