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Histologic subtype impacts cancer-specific survival in patients with sarcomatoid-variant renal cell carcinoma treated surgically.

Abstract：

PURPOSE:To report survival outcomes of patients treated surgically for sarcomatoid-variant renal cell carcinomas (sRCC) and to assess whether the underlying histologic subtype is an independent predictor of outcome. METHODS:One hundred and fifty-one patients underwent surgery at a referral center between 1991 and 2014 and had sRCC in final pathology. Kaplan-Meier curves for metastasis-free survival and cancer-specific survival (CSS) were calculated, and the log-rank test assessed differences between clear cell sRCC and nonclear cell sRCC. Cox regression models were generated to test the prognostic value of histologic subtype. RESULTS:Of 151 patients, 120 (79 %) had clear cell sRCC and 31 (21 %) had nonclear cell sRCC. Ninety-eight (65 %) patients had M0/Mx disease at presentation. Among those M0/Mx patients, metastasis-free survival probabilities were 49 % at 2 years [95 % confidence interval (CI) 38-60] and 39 % at 5 years (95 % CI 28-50), while CSS probabilities were 50 % at 2 years (95 % CI 41-58) and 32 % at 5 years (95 % CI 24-41). There was no significant difference in metastasis-free survival between clear cell and nonclear cell sRCC (p = 0.8). However, patients with nonclear cell sRCC had significantly lower CSS than patients with clear cell sRCC (p = 0.035). In multivariable analyses, nonclear cell sRCC conferred a higher risk of cancer-specific death compared with clear cell sRCC (HR 2.30, 95 % CI 1.38-3.82, p = 0.001). CONCLUSIONS:In a cohort of patients treated surgically, the underlying histologic subtype of sRCC had an impact on CSS. These results present valuable information for individual counseling and patient selection in clinical trials.

journal_name

World J Urol

journal_title

World journal of urology

authors

Nguyen DP,Vilaseca A,Vertosick EA,Corradi RB,Touijer KA,Benfante NE,Sjoberg DD,Russo P

doi

10.1007/s00345-015-1644-y

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

539-44

issue

4

eissn

0724-4983

issn

1433-8726

pii

10.1007/s00345-015-1644-y

journal_volume

34

pub_type

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