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World J Urol. 2016 May;34(5):687-93. doi: 10.1007/s00345-015-1692-3. Epub 2015 Sep 25.

Clinically localized type 1 and 2 papillary renal cell carcinomas have similar survival outcomes following surgery.

Author information

1
Section of Urology, Department of Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC6038, J-664, Chicago, IL, 60637, USA. rodrigoledezma@gmail.com.
2
Section of Urology, Department of Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC6038, J-664, Chicago, IL, 60637, USA.
3
Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA.
4
Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
5
Department of Urology, Columbia University, New York, NY, USA.
6
Division of Urologic Oncology, Fox Chase Cancer Center Temple University Health System, Philadelphia, PA, USA.
7
Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
8
Department of Pathology, Columbia University, New York, NY, USA.

Abstract

PURPOSE:

We aimed to determine incidence, pathologic findings, prognostic factors and clinical outcomes for patients with clinically localized papillary RCC.

METHODS:

Demographic, clinical and pathologic findings were collected on all patients with PRCC undergoing surgery at four academic medical centers. The primary endpoint was cancer-specific survival (CSS). Relapse-free survival (RFS) and overall survival (OS) were secondary endpoints. Kaplan-Meier estimates were obtained, and Cox proportional hazard regression models were used to assess predictors of mortality and relapse.

RESULTS:

We identified 626 PRCC, of which 373 (60 %) were type 1 and 253 (40 %) were type 2, with three-quarters of all tumors being pT1. Compared to patients with type 1, those with type 2 were older (mean age: 63 vs 61; p = 0.02), presented more commonly with symptoms (13 vs 7 %; p = 0.02) and had larger mean tumor size (5.2 vs 4.3 cm; p = 0.001). With a median follow-up of 41 months (IQR: 16-68), 92 patients had died of PRCC (15 %), 48 (8 %) experienced relapse, and 101 died from all causes (16 %). The estimated 5-year CSS, RFS and OS were 83, 91 and 82 %, respectively. In multivariable analysis, older age, T stage and nodal status were predictors of CSS and OS. However, PRCC subtype was not a predictor of CSS, RFS or OS.

CONCLUSION:

While patients with type 2 PRCC appear to present with more advanced disease than patients with type 1, PRCC subtype does not appear to be an independent predictor of CSS, RFS or OS for treated localized disease.

KEYWORDS:

Histological type; Papillary RCC; Prognosis; Survival

PMID:
26407582
DOI:
10.1007/s00345-015-1692-3
[Indexed for MEDLINE]

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