Prognostic factors in a large multi-institutional series of papillary renal cell carcinoma

Alessandro Zucchi, Giacomo Novara, Elisabetta Costantini, Alessandro Antonelli, Marco Carini, Giorgio Carmignani, Sergio Cosciani Cunico, Dario Fontana, Nicola Longo, Guido Martignoni, Andrea Minervini, Vincenzo Mirone, Massimo Porena, Marco Roscigno, Riccardo Schiavina, Claudio Simeone, Alchiede Simonato, Salvatore Siracusano, Carlo Terrone, Vincenzo Ficarra

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: • To investigate cancer-related outcomes and prognostic factors of papillary renal cell carcinoma (pRCC) in a large multicentre data set. • Oncological outcome and prognostic factors of pRCC have been limitedly evaluated in comparison with the most common RCC subtype, clear cell RCC. PATIENTS AND METHODS: • From a multicentre retrospective database, including 5463 patients who were surgically treated for RCC at 16 Italian academic centres between 1995 and 2007, 577 patients with pRCC were identified. • Univariable and multivariable Cox regression models were performed to identify prognostic factors predictive of recurrence-free survival (RFS) and cancer-specific survival (CSS) after surgery. RESULTS: • At a median (interquartile range) follow-up of 39.2 (21.7-72) months, 81 (14%) patients had experienced disease progression and 63 (11%) patients had died from disease; the 5-year RFS estimate was 85.5%. • In multivariable analysis, pathological N stage (pooled P <0.001), M stage (hazard ratio, 2.9; P = 0.007) and Fuhrman nuclear grade (pooled P = 0.039) were all independent predictors of RFS; the 5-year CSS estimate was 87.9%. • In Cox multivariable analysis, an independent predictive role was reconfirmed for mode of presentation (pooled P = 0.038), pathological N stage (pooled P <0.001), M stage (hazard ratio, 2.4; P = 0.049) and Fuhrman nuclear grade (pooled P = 0.037). CONCLUSIONS: • Patients with pRCC have a low risk of tumour recurrence and cancer-related death after surgery. • Fuhrman nuclear grade was found to be a stronger predictor of both RFS and CSS, whereas only a non-statistically significant trend was found for the 2009 pathological T stage.

Original languageEnglish
Pages (from-to)1140-1146
Number of pages7
JournalBJU International
Issue number8
Publication statusPublished - Apr 2012


  • Papillary renal cell carcinoma
  • Prognostic factors

ASJC Scopus subject areas

  • Urology


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