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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2021

Open Access 01-02-2021 | Kidney Cancer | Urologic Oncology

Nephron-Sparing Surgery for Adult Xp11.2 Translocation Renal Cell Carcinoma at Clinical T1 Stage: A Multicenter Study in China

Authors: Ning Liu, PhD, Feng Qu, PhD, Qiancheng Shi, PhD, Wenyuan Zhuang, PhD, Wenliang Ma, MD, Zhenhao Yang, MD, Jing Sun, MD, Wei Xu, PhD, Lihua Zhang, PhD, Ruipeng Jia, PhD, Linfeng Xu, PhD, Xiaozhi Zhao, PhD, Xiaogong Li, MD, Gutian Zhang, MD, Hongqian Guo, PhD, Dongmei Li, PhD, MD, Weidong Gan, PhD

Published in: Annals of Surgical Oncology | Issue 2/2021

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Abstract

Purpose

To evaluate the oncologic efficacy and feasibility of nephron-sparing surgery (NSS) in adult Xp11.2 translocation renal cell carcinoma (RCC).

Patients and Methods

Seventy patients with Xp11.2 translocation RCC and 273 with conventional RCC from five institutions in Nanjing were retrospectively studied. All patients were older than 18 years and were categorized into clinical T1 (cT1) stage using preoperative imaging. Using the preoperative imaging and electronic medical records, anatomical and pathological features were collected and analyzed.

Results

Among patients with Xp11.2 translocation RCC, 18/36 (50.0%) with cT1a and 12/34 (35.3%) with cT1b tumors underwent NSS. The respective proportions in the conventional RCC group were 121/145 (83.4%) and 93/128 (72.7%). Among cT1a tumors, the Xp11.2 translocation RCCs tended to be adjacent to the collecting system, sinus, and axial renal midline compared with conventional RCCs. Patients with Xp11.2 translocation RCCs who underwent NSS had comparable progression-free survival (PFS) and overall survival to radical nephrectomy (RN) patients (P > 0.05). Among cT1b tumors, surgical margin positivity and pelvicalyceal, vascular, and region lymphatic involvement were more likely to occur in the Xp11.2 translocation RCCs (P < 0.05). Patients with Xp11.2 translocation RCC who underwent RN had a more favorable PFS than those who underwent NSS (P = 0.048). However, multivariate analysis of PFS did not identify surgical method as a risk factor (P = 0.089).

Conclusions

Among adults with Xp11.2 translocation RCC, NSS can be an alternative for patients with cT1a tumor but should be performed with more deliberation in patients with cT1b tumors.
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Literature
1.
Lopez-Beltran A, Scarpelli M, Montironi R, Kirkali Z. 2004 WHO classification of the renal tumors of the adults. Eur Urol. 2006;49(5):798–805.PubMedCrossRef
2.
Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO classification of tumours of the urinary system and male genital organs-part A: renal, penile, and testicular tumours. Eur Urol. 2016;70(1):93–105.PubMedCrossRef
3.
Qiu R, Bing G, Zhou XJ. Xp11.2 Translocation renal cell carcinomas have a poorer prognosis than non-Xp11.2 translocation carcinomas in children and young adults: a meta-analysis. Int J Surg Pathol. 2010;18(6):458–64.
4.
Xu L, Yang R, Gan W, et al. Xp11.2 translocation renal cell carcinomas in young adults. BMC Urol. 2015;15:57.
5.
Sukov WR, Hodge JC, Lohse CM, et al. TFE3 rearrangements in adult renal cell carcinoma: clinical and pathologic features with outcome in a large series of consecutively treated patients. Am J Surg Pathol. 2012;36(5):663–70.
6.
Ellis CL, Eble JN, Subhawong AP, et al. Clinical heterogeneity of Xp11 translocation renal cell carcinoma: impact of fusion subtype, age and stage. Mod Pathol. 2014;27(6):875–86.PubMedCrossRef
7.
7. Argani P, Olgac S, Tickoo SK, et al. Xp11 translocation renal cell carcinoma in adults: expanded clinical, pathologic, and genetic spectrum. Am J Surg Pathol. 2007;31(8):1149–60.PubMedCrossRef
8.
Van Poppel H, Da Pozzo L, Albrecht W, et al. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2011;59(4):543–52.PubMedCrossRef
9.
Ljungberg B, Albiges L, Abu-Ghanem Y, et al. European Association of Urology guidelines on renal cell carcinoma: The 2019 update. Eur Urol. 2019;75(5):799–810.PubMedCrossRef
10.
Yoo S, You D, Jeong IG, et al. Histologic subtype needs to be considered after partial nephrectomy in patients with pathologic T1a renal cell carcinoma: papillary vs. clear cell renal cell carcinoma. J Cancer Res Clin Oncol. 2017;143(9):1845–51.
11.
Uzzo RG, Novick AC. Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol. 2001;166(1):6–18.PubMedCrossRef
12.
Argani P, Lal P, Hutchinson B, et al. Aberrant nuclear immunoreactivity for TFE3 in neoplasms with TFE3 gene fusions: a sensitive and specific immunohistochemical assay. Am J Surg Pathol. 2003;27(6):750–61.PubMedCrossRef
13.
Chen X, Yang Y, Gan W, et al. Newly designed break-apart and ASPL-TFE3 dual-fusion FISH assay are useful in diagnosing Xp11.2 translocation renal cell carcinoma and ASPL-TFE3 renal cell carcinoma: a STARD-compliant article. Medicine (Baltimore). 2015;94(19):e873.
14.
Green WM, Yonescu R, Morsberger L, et al. Utilization of a TFE3 break-apart FISH assay in a renal tumor consultation service. Am J Surg Pathol. 2013;37(8):1150–63.PubMedCrossRef
15.
Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182(3):844–53.
16.
de Jong B, Molenaar IM, Leeuw JA, Idenberg VJ, Oosterhuis JW. Cytogenetics of a renal adenocarcinoma in a 2-year-old child. Cancer Genet Cytogenet. 1986;21(2):165–9.PubMedCrossRef
17.
Argani P, Antonescu CR, Illei PB, et al. Primary renal neoplasms with the ASPL-TFE3 gene fusion of alveolar soft part sarcoma: a distinctive tumor entity previously included among renal cell carcinomas of children and adolescents. Am J Pathol. 2001;159(1):179–92.PubMedPubMedCentralCrossRef
18.
Argani P, Antonescu CR, Couturier J, et al. PRCC-TFE3 renal carcinomas: morphologic, immunohistochemical, ultrastructural, and molecular analysis of an entity associated with the t(X;1)(p11.2;q21). Am J Surg Pathol. 2002;26(12):1553–66.
19.
Cheng X, Gan W, Zhang G, Li X, Guo H. Clinical characteristics of XP11.2 translocation/TFE3 gene fusion renal cell carcinoma: a systematic review and meta-analysis of observational studies. BMC Urol. 2016;16(1):40.
20.
Liu N, Wang Z, Gan W, et al. Renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions: clinical features, treatments and prognosis. Plos One. 2016;11(11).
21.
Taneja K, Arora S, Rogers CG, Gupta NS, Williamson SR. Pathological staging of renal cell carcinoma: a review of 300 consecutive cases with emphasis on retrograde venous invasion. Histopathology. 2018;73(4):681–91.PubMedCrossRef
22.
Williamson SR, Taneja K, Cheng L. Renal cell carcinoma staging: pitfalls, challenges, and updates. Histopathology. 2019;74(1):18–30.PubMedCrossRef
23.
Bonsib SM. T2 clear cell renal cell carcinoma is a rare entity: a study of 120 clear cell renal cell carcinomas. J Urol. 2005;174(4 Pt 1):1199–202; discussion 202.
24.
Sokhi HK, Mok WY, Patel U. Stage T3a renal cell carcinoma: staging accuracy of CT for sinus fat, perinephric fat or renal vein invasion. Br J Radiol. 2015;88(1045):20140504.PubMedCrossRef
25.
Tsili AC, Argyropoulou MI. Advances of multidetector computed tomography in the characterization and staging of renal cell carcinoma. World J Radiol. 2015;7(6):110–27.PubMedPubMedCentralCrossRef
26.
Cheng X, He J, Gan W, et al. Pseudocapsule of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion: a clue for tumor enucleation? Int J Clin Exp Pathol. 2015;8(5):5403–10.
27.
Geller JI, Dome JS. Local lymph node involvement does not predict poor outcome in pediatric renal cell carcinoma. Cancer. 2004;101(7):1575–83.PubMedCrossRef
28.
Ma W, Liu N, Zhuang W, et al. Comparative clinicopathologic characteristics and outcomes of paediatric and adult Xp11 translocation renal cell carcinomas: a retrospective multicentre study in China. Sci Rep. 2020;10(1):2249.PubMedPubMedCentralCrossRef
29.
Li Y, Ding YU, Chen D, et al. Renal cell carcinoma growing into the renal pelvis and mimicking transitional cell carcinoma: A case report and literature review. Oncol Lett. 2015;9(4):1869–72.PubMedPubMedCentralCrossRef
30.
Chauhan NS, Bharti R, Chander B, Kumar S. Pediatric clear cell renal cell carcinoma with pelvicalyceal system invasion and contiguous extension up to bladder: novel and bizarre tumor behaviour. Pol J Radiol. 2016;81:256–60.PubMedPubMedCentralCrossRef
31.
Kitazono MT, Coakley FV, Naeger DM, et al. CT of unusual renal masses invading the pelvicaliceal system: potential mimics of upper tract transitional cell carcinoma. Clin Imaging. 2011;35(1):77–80.PubMedCrossRef
32.
Bata P, Tarnoki DL, Tarnoki AD, et al. Transitional cell and clear cell renal carcinoma: differentiation of distinct histological types with multiphase CT. Acta Radiol. 2014;55(9):1112–9.PubMedCrossRef
33.
Gulati M, Gore JL, Pantuck AJ, et al. Ureteral tumor thrombus from renal cell carcinoma extending into bladder. Urol Oncol. 2007;25(5):393–5.PubMedCrossRef
34.
Wang HK, Zhu Y, Yao XD, et al. External validation of a nomogram using RENAL nephrometry score to predict high grade renal cell carcinoma. J Urol. 2012;187(5):1555–60.PubMedCrossRef
35.
Satasivam P, Sengupta S, Rajarubendra N, et al. Renal lesions with low R.E.N.A.L nephrometry score are associated with more indolent renal cell carcinomas (RCCs) or benign histology: findings in an Australian cohort. BJU Int. 2012;109 Suppl 3:44–7.
36.
Mullins JK, Kaouk JH, Bhayani S, et al. Tumor complexity predicts malignant disease for small renal masses. J Urol. 2012;188(6):2072–6.PubMedCrossRef
37.
Kutikov A, Smaldone MC, Egleston BL, et al. Anatomic features of enhancing renal masses predict malignant and high-grade pathology: a preoperative nomogram using the RENAL Nephrometry score. Eur Urol. 2011;60(2):241–8.PubMedPubMedCentralCrossRef
38.
Kopp RP, Mehrazin R, Palazzi KL, et al. Survival outcomes after radical and partial nephrectomy for clinical T2 renal tumours categorised by R.E.N.A.L. nephrometry score. BJU Int. 2014;114(5):708–18.
39.
Nagahara A, Uemura M, Kawashima A, et al. R.E.N.A.L. nephrometry score predicts postoperative recurrence of localized renal cell carcinoma treated by radical nephrectomy. Int J Clin Oncol. 2016;21(2):367–72.
40.
Gorin MA, Ball MW, Pierorazio PM, Argani P, Allaf ME. Partial nephrectomy for the treatment of translocation renal cell carcinoma. Clin Genitourin Cancer. 2015;13(3):e199-201.PubMedCrossRef
41.
Camparo P, Vasiliu V, Molinie V, et al. Renal translocation carcinomas: clinicopathologic, immunohistochemical, and gene expression profiling analysis of 31 cases with a review of the literature. Am J Surg Pathol. 2008;32(5):656–70.PubMedCrossRef
42.
Ramphal R, Pappo A, Zielenska M, Grant R, Ngan BY. Pediatric renal cell carcinoma: clinical, pathologic, and molecular abnormalities associated with the members of the mit transcription factor family. Am J Clin Pathol. 2006;126(3):349–64.PubMedCrossRef
43.
Liu C, Zhang W, Song H. Nephron-sparing surgery in the treatment of pediatric renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions. J Pediatr Surg. 2017;52(9):1492–5.
44.
He J, Gan W, Liu S, et al. Dynamic computed tomographic features of adult renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions: comparison with clear cell renal cell carcinoma. J Comput Assist Tomogr. 2015;39(5):730–6.
45.
He J, Zhou K, Zhu B, et al. Dynamic contrast-enhanced CT characterization of Xp11.2 translocation/TFE3 gene fusions versus papillary renal cell carcinomas. Biomed Res Int. 2015;2015:1–8.
46.
Wang W, Ding J, Li Y, et al. Magnetic resonance imaging and computed tomography characteristics of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion. PLoS One. 2014;9(6):e99990.
47.
Ling W, Ma X, Luo Y, et al. Ultrasonographic findings of renal cell carcinomas associated with Xp11.2 translocation/TFE3 gene fusion. Contrast Media Mol Imaging. 2017;2017:2958357.
Metadata
Title
Nephron-Sparing Surgery for Adult Xp11.2 Translocation Renal Cell Carcinoma at Clinical T1 Stage: A Multicenter Study in China
Authors
Ning Liu, PhD
Feng Qu, PhD
Qiancheng Shi, PhD
Wenyuan Zhuang, PhD
Wenliang Ma, MD
Zhenhao Yang, MD
Jing Sun, MD
Wei Xu, PhD
Lihua Zhang, PhD
Ruipeng Jia, PhD
Linfeng Xu, PhD
Xiaozhi Zhao, PhD
Xiaogong Li, MD
Gutian Zhang, MD
Hongqian Guo, PhD
Dongmei Li, PhD, MD
Weidong Gan, PhD
Publication date
01-02-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08813-y

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