Papillary type 2 versus clear cell renal cell carcinoma: Survival outcomes

G. Simone, G. Tuderti, M. Ferriero, R. Papalia, L. Misuraca, F. Minisola, M. Costantini, R. Mastroianni, S. Sentinelli, Salvatore Guaglianone, M. Gallucci

Research output: Contribution to journalArticle

Abstract

Aim To compare the cancer specific survival (CSS) between p2-RCC and a Propensity Score Matched (PSM) cohort of cc-RCC patients. Methods Fifty-five (4.6%) patients with p2-RCC and 920 cc-RCC patients were identified within a prospectively maintained institutional dataset of 1205 histologically proved RCC patients treated with either RN or PN. Univariable and multivariable Cox regression analyses were used to identify predictors of CSS after surgical treatment. A 1:2 PSM analysis based on independent predictors of oncologic outcomes was employed and CSS was compared between PSM selected cc-RCC patients using Kaplan–Meier and Cox regression analysis. Results Overall, 55 (4.6%) p2-RCC and 920 (76.3%) cc-RCC patients were selected from the database; p2-RCC were significantly larger (p = 0.001), more frequently locally advanced (p < 0.001) and node positive (p < 0.001) and had significantly higher Fuhrman grade (p < 0.001) than cc-RCC. On multivariable Cox regression analysis age (p = 0.025), histologic subtype (p = 0.029), pN stage (p = 0.006), size, pT stage, cM stage, sarcomatoid features and Fuhrman grade (all p < 0.001) were independent predictors of CSS. After applying the PSM, 82 cc-RCC selected cases were comparable to 41 p2-RCC for age (p = 0.81), tumor size (p = 0.39), pT (p = 1.00) and pN (p = 0.62) stages, cM stage (p = 0.71) and Fuhrman grade (p = 1). In this PSM cohort, 5 yr CSS was significantly lower in the p2-RCC (63% vs 72.4%; p = 0.047). At multivariable Cox analysis p2 histology was an independent predictor of CSM (HR 2.46, 95% CI 1.04–5.83; p = 0.041). Conclusions We confirmed the tendency of p2-RCC to present as locally advanced and metastatic disease more frequently than cc-RCC and demonstrated p2-RCC histology as an independent predictor of worse oncologic outcomes.

Original languageEnglish
Pages (from-to)1744-1750
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume42
Issue number11
DOIs
Publication statusPublished - Nov 1 2016

Keywords

  • Histologic subtypes
  • Papillary
  • Prognosis
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Simone, G., Tuderti, G., Ferriero, M., Papalia, R., Misuraca, L., Minisola, F., Costantini, M., Mastroianni, R., Sentinelli, S., Guaglianone, S., & Gallucci, M. (2016). Papillary type 2 versus clear cell renal cell carcinoma: Survival outcomes. European Journal of Surgical Oncology, 42(11), 1744-1750. https://doi.org/10.1016/j.ejso.2016.08.003