Published in:
01-03-2016 | Original Article
The subclassification of papillary renal cell carcinoma does not affect oncological outcomes after nephron sparing surgery
Authors:
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
Published in:
World Journal of Urology
|
Issue 3/2016
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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.