Skip to main content
Erschienen in: World Journal of Urology 3/2016

01.03.2016 | Original Article

The subclassification of papillary renal cell carcinoma does not affect oncological outcomes after nephron sparing surgery

verfasst von: Pierre Bigot, Jean-Christophe Bernhard, Inderbir S. Gill, Nam Son Vuong, Grégory Verhoest, Vincent Flamand, Boris Reix, Evren Suer, Ilker Gökce, Jean Baptiste Beauval, François Xavier Nouhaud, Masatoshi Eto, Eduard Baco, Toru Matsugasumi, Yvonne Chowaniec, Jérôme Rigaud, Claire Lenormand, Christian Pfister, Jean François Hetet, Guillaume Ploussard, Morgan Roupret, Priscilla Léon, Adnan El Bakri, Stéphane Larré, Xavier Tillou, Arnaud Doerfler, Aurélien Descazeaud, Nicolas Koutlidis, Alexandre Schneider, Philippe Sebe, Alexandre Ingels, Abdel Rahmène Azzouzi, Michel Soulié, Arnaud Méjean, Karim Bensalah, Jean-Jacques Patard, the members of the Kidney Cancer group of the CCAFU

Erschienen in: World Journal of Urology | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To evaluate the oncological outcomes of papillary renal cell carcinoma (pRCC) following nephron sparing surgery (NSS) and to determine whether the subclassification type of pRCC could be a prognostic factor for recurrence, progression, and specific death.

Materials and methods

An international multicentre retrospective study involving 19 institutions and the French network for research on kidney cancer was conducted after IRB approval. We analyzed data of all patients with pRCC who were treated by NSS between 2004 and 2014.

Results

We included 486 patients. Tumors were type 1 pRCC in 369 (76 %) cases and type 2 pRCC in 117 (24 %) cases. After a mean follow-up of 35 (1–120) months, 8 (1.6 %) patients experienced a local recurrence, 12 (1.5 %) had a metastatic progression, 24 (4.9 %) died, and 7 (1.4 %) died from cancer. Patients with type I pRCC had more grade II (66.3 vs. 46.1 %; p < 0.001) and less grade III (20 vs. 41 %; p < 0.001) tumors. Three-year estimated cancer-free survival (CFS) rate for type 1 pRCC was 96.5 % and for type 2 pRCC was 95.1 % (p = 0.894), respectively. Three-year estimated cancer-specific survival rate for type 1 pRCC was 98.4 % and for type 2 pRCC was 97.3 % (p = 0.947), respectively. Tumor stage superior to pT1 was the only prognostic factor for CFS (HR 3.5; p = 0.03).

Conclusion

Histological subtyping of pRCC has no impact on oncologic outcomes after nephron sparing surgery. In this selected population of pRCC tumors, we found that tumor stage is the only prognostic factor for cancer-free survival.
Literatur
1.
Zurück zum Zitat Patard JJ et al (2005) Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol 23(12):2763–2771CrossRefPubMed Patard JJ et al (2005) Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol 23(12):2763–2771CrossRefPubMed
2.
Zurück zum Zitat Mancilla-Jimenez R, Stanley RJ, Blath RA (1976) Papillary renal cell carcinoma: a clinical, radiologic, and pathologic study of 34 cases. Cancer 38(6):2469–2480CrossRefPubMed Mancilla-Jimenez R, Stanley RJ, Blath RA (1976) Papillary renal cell carcinoma: a clinical, radiologic, and pathologic study of 34 cases. Cancer 38(6):2469–2480CrossRefPubMed
3.
Zurück zum Zitat Amin MB et al (2002) Prognostic impact of histologic subtyping of adult renal epithelial neoplasms: an experience of 405 cases. Am J Surg Pathol 26(3):281–291CrossRefPubMed Amin MB et al (2002) Prognostic impact of histologic subtyping of adult renal epithelial neoplasms: an experience of 405 cases. Am J Surg Pathol 26(3):281–291CrossRefPubMed
4.
Zurück zum Zitat Pignot G et al (2007) Survival analysis of 130 patients with papillary renal cell carcinoma: prognostic utility of type 1 and type 2 subclassification. Urology 69(2):230–235CrossRefPubMed Pignot G et al (2007) Survival analysis of 130 patients with papillary renal cell carcinoma: prognostic utility of type 1 and type 2 subclassification. Urology 69(2):230–235CrossRefPubMed
5.
Zurück zum Zitat Delahunt B, Eble JN (1997) Papillary renal cell carcinoma: a clinicopathologic and immunohistochemical study of 105 tumors. Mod Pathol 10(6):537–544PubMed Delahunt B, Eble JN (1997) Papillary renal cell carcinoma: a clinicopathologic and immunohistochemical study of 105 tumors. Mod Pathol 10(6):537–544PubMed
6.
Zurück zum Zitat Sibony M, Vieillefond A (2008) Non clear cell renal cell carcinoma. 2008 update in renal tumor pathology. Ann Pathol 28(5):381–401CrossRefPubMed Sibony M, Vieillefond A (2008) Non clear cell renal cell carcinoma. 2008 update in renal tumor pathology. Ann Pathol 28(5):381–401CrossRefPubMed
7.
Zurück zum Zitat Amin MB et al (1997) Papillary (chromophil) renal cell carcinoma: histomorphologic characteristics and evaluation of conventional pathologic prognostic parameters in 62 cases. Am J Surg Pathol 21(6):621–635CrossRefPubMed Amin MB et al (1997) Papillary (chromophil) renal cell carcinoma: histomorphologic characteristics and evaluation of conventional pathologic prognostic parameters in 62 cases. Am J Surg Pathol 21(6):621–635CrossRefPubMed
8.
Zurück zum Zitat Beck SD et al (2004) Effect of papillary and chromophobe cell type on disease-free survival after nephrectomy for renal cell carcinoma. Ann Surg Oncol 11(1):71–77CrossRefPubMed Beck SD et al (2004) Effect of papillary and chromophobe cell type on disease-free survival after nephrectomy for renal cell carcinoma. Ann Surg Oncol 11(1):71–77CrossRefPubMed
9.
Zurück zum Zitat Chow GK, Myles J, Novick AC (2001) The Cleveland Clinic experience with papillary (chromophil) renal cell carcinoma: clinical outcome with histopathological correlation. Can J Urol 8(2):1223–1228PubMed Chow GK, Myles J, Novick AC (2001) The Cleveland Clinic experience with papillary (chromophil) renal cell carcinoma: clinical outcome with histopathological correlation. Can J Urol 8(2):1223–1228PubMed
10.
Zurück zum Zitat Delahunt B et al (2001) Morphologic typing of papillary renal cell carcinoma: comparison of growth kinetics and patient survival in 66 cases. Hum Pathol 32(6):590–595CrossRefPubMed Delahunt B et al (2001) Morphologic typing of papillary renal cell carcinoma: comparison of growth kinetics and patient survival in 66 cases. Hum Pathol 32(6):590–595CrossRefPubMed
11.
Zurück zum Zitat Huang WC et al (2006) Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 7(9):735–740PubMedCentralCrossRefPubMed Huang WC et al (2006) Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 7(9):735–740PubMedCentralCrossRefPubMed
12.
Zurück zum Zitat Sun M et al (2012) A non-cancer-related survival benefit is associated with partial nephrectomy. Eur Urol 61(4): 725–731CrossRefPubMed Sun M et al (2012) A non-cancer-related survival benefit is associated with partial nephrectomy. Eur Urol 61(4): 725–731CrossRefPubMed
13.
Zurück zum Zitat Kaushik D, Kim SP, Childs MA et al (2013) Overall survival and development of stage IV chronic kidney disease in patients undergoing partial and radical nephrectomy for benign renal tumors. Eur Urol 64(4):600–606CrossRefPubMed Kaushik D, Kim SP, Childs MA et al (2013) Overall survival and development of stage IV chronic kidney disease in patients undergoing partial and radical nephrectomy for benign renal tumors. Eur Urol 64(4):600–606CrossRefPubMed
14.
Zurück zum Zitat Tan HJ et al (2012) Long-term survival following partial vs radical nephrectomy among older patients with early-stage kidney cancer. JAMA 307(15):1629–1635CrossRefPubMed Tan HJ et al (2012) Long-term survival following partial vs radical nephrectomy among older patients with early-stage kidney cancer. JAMA 307(15):1629–1635CrossRefPubMed
15.
Zurück zum Zitat Bigot P et al (2010) How radical nephrectomy compares to partial nephrectomy for the treatment of pT1a papillary renal cell carcinomas? Prog Urol 20(5):350–355CrossRefPubMed Bigot P et al (2010) How radical nephrectomy compares to partial nephrectomy for the treatment of pT1a papillary renal cell carcinomas? Prog Urol 20(5):350–355CrossRefPubMed
16.
Zurück zum Zitat Crepel M et al (2009) Does histologic subtype affect oncologic outcomes after nephron-sparing surgery? Urology 74(4):842–845CrossRefPubMed Crepel M et al (2009) Does histologic subtype affect oncologic outcomes after nephron-sparing surgery? Urology 74(4):842–845CrossRefPubMed
17.
Zurück zum Zitat Sobin LH, Gospodarowicz M, Wittekind C (eds) (2009) TNM classification of malignant tumors. UICC International Union Against Cancer, 7th edn. Wiley-Blackwell, New York, pp 255–257 Sobin LH, Gospodarowicz M, Wittekind C (eds) (2009) TNM classification of malignant tumors. UICC International Union Against Cancer, 7th edn. Wiley-Blackwell, New York, pp 255–257
18.
Zurück zum Zitat Mejean A et al (2003) Prognostic factors for the survival of patients with papillary renal cell carcinoma: meaning of histological typing and multifocality. J Urol 170(3):764–767CrossRefPubMed Mejean A et al (2003) Prognostic factors for the survival of patients with papillary renal cell carcinoma: meaning of histological typing and multifocality. J Urol 170(3):764–767CrossRefPubMed
19.
Zurück zum Zitat Krejci KG et al (2003) Nephron-sparing surgery for renal cell carcinoma: clinicopathologic features predictive of patient outcome. Urology 62(4):641–646CrossRefPubMed Krejci KG et al (2003) Nephron-sparing surgery for renal cell carcinoma: clinicopathologic features predictive of patient outcome. Urology 62(4):641–646CrossRefPubMed
20.
Zurück zum Zitat Steinestel J et al (2014) Positive surgical margins in nephron-sparing surgery: risk factors and therapeutic consequences. World J Surg Oncol 12:252PubMedCentralCrossRefPubMed Steinestel J et al (2014) Positive surgical margins in nephron-sparing surgery: risk factors and therapeutic consequences. World J Surg Oncol 12:252PubMedCentralCrossRefPubMed
21.
Zurück zum Zitat Kwon EO et al (2007) Impact of positive surgical margins in patients undergoing partial nephrectomy for renal cortical tumours. BJU Int 99(2):286–289CrossRefPubMed Kwon EO et al (2007) Impact of positive surgical margins in patients undergoing partial nephrectomy for renal cortical tumours. BJU Int 99(2):286–289CrossRefPubMed
22.
Zurück zum Zitat Bensalah K et al (2010) Positive surgical margin appears to have negligible impact on survival of renal cell carcinomas treated by nephron-sparing surgery. Eur Urol 57(3):466–471CrossRefPubMed Bensalah K et al (2010) Positive surgical margin appears to have negligible impact on survival of renal cell carcinomas treated by nephron-sparing surgery. Eur Urol 57(3):466–471CrossRefPubMed
23.
Zurück zum Zitat Bernhard JC et al (2010) Predictive factors for ipsilateral recurrence after nephron-sparing surgery in renal cell carcinoma. Eur Urol 57(6):1080–1086CrossRefPubMed Bernhard JC et al (2010) Predictive factors for ipsilateral recurrence after nephron-sparing surgery in renal cell carcinoma. Eur Urol 57(6):1080–1086CrossRefPubMed
24.
Zurück zum Zitat Dimarco DS et al (2004) Long-term survival of patients with unilateral sporadic multifocal renal cell carcinoma according to histologic subtype compared with patients with solitary tumors after radical nephrectomy. Urology 64(3):462–467CrossRefPubMed Dimarco DS et al (2004) Long-term survival of patients with unilateral sporadic multifocal renal cell carcinoma according to histologic subtype compared with patients with solitary tumors after radical nephrectomy. Urology 64(3):462–467CrossRefPubMed
25.
Zurück zum Zitat Gorin MA et al (2013) Outcomes and predictors of clinical T1 to pathological T3a tumor up-staging after robotic partial nephrectomy: a multi-institutional analysis. J Urol 190(5):1907–1911CrossRefPubMed Gorin MA et al (2013) Outcomes and predictors of clinical T1 to pathological T3a tumor up-staging after robotic partial nephrectomy: a multi-institutional analysis. J Urol 190(5):1907–1911CrossRefPubMed
Metadaten
Titel
The subclassification of papillary renal cell carcinoma does not affect oncological outcomes after nephron sparing surgery
verfasst von
Pierre Bigot
Jean-Christophe Bernhard
Inderbir S. Gill
Nam Son Vuong
Grégory Verhoest
Vincent Flamand
Boris Reix
Evren Suer
Ilker Gökce
Jean Baptiste Beauval
François Xavier Nouhaud
Masatoshi Eto
Eduard Baco
Toru Matsugasumi
Yvonne Chowaniec
Jérôme Rigaud
Claire Lenormand
Christian Pfister
Jean François Hetet
Guillaume Ploussard
Morgan Roupret
Priscilla Léon
Adnan El Bakri
Stéphane Larré
Xavier Tillou
Arnaud Doerfler
Aurélien Descazeaud
Nicolas Koutlidis
Alexandre Schneider
Philippe Sebe
Alexandre Ingels
Abdel Rahmène Azzouzi
Michel Soulié
Arnaud Méjean
Karim Bensalah
Jean-Jacques Patard
the members of the Kidney Cancer group of the CCAFU
Publikationsdatum
01.03.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 3/2016
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-015-1634-0

Weitere Artikel der Ausgabe 3/2016

World Journal of Urology 3/2016 Zur Ausgabe

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.