title: Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience.
abstract: OBJECTIVE
  To analyze to what extent histologic subtype is of prognostic importance in renal cell carcinoma based on a large, international, multicenter experience.
  
  
  METHODS
  Four thousand sixty-three patients from eight international centers were included in this retrospective study. Histologic subtype (1997 International Union Against Cancer [UICC] criteria of tumor response), age, sex, TNM stage, Fuhrman grade, tumor size, Eastern Cooperative Oncology Goup performance status (ECOG PS), and overall survival were determined in all cases. The prognostic values of clear cell, papillary, and chromophobe histologic features were assessed by uni- and multivariate analysis using the Kaplan-Meier method and Cox model, respectively.
  
  
  RESULTS
  Clear cell, papillary, and chromophobe carcinomas accounted for 3,564 (87.7%), 396 (9.7%) and 103 (2.5%) cases, respectively. In univariate analysis, a trend toward a better survival was observed when clear cell, papillary, and chromophobe histologies were considered prognostic categories (log-rank P = .0007). However, in multivariate analysis, TNM stage, Fuhrman grade and ECOG PS, but not histology, were retained as independent prognostic variables (P < .001).
  
  
  CONCLUSIONS
  The stratification in three main renal cell carcinoma histologic subtypes as defined by the 1997 UICC-American Joint Committee on Cancer consensus should not be considered a major prognostic variable comparable to TNM stage, Fuhrman grade and ECOG PS.
authors.affiliation: Department of Urology, Rennes University Hospital, Rennes, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Leray
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rioux-Leclercq
authors.forename: Luca
authors.initials: L
authors.lastname: Cindolo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
authors.forename: Amnon
authors.initials: A
authors.lastname: Zisman
authors.forename: Alexandre
authors.initials: A
authors.lastname: De La Taille
authors.forename: Jacques
authors.initials: J
authors.lastname: Tostain
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
authors.forename: Claude C
authors.initials: CC
authors.lastname: Abbou
authors.forename: Bernard
authors.initials: B
authors.lastname: Lobel
authors.forename: François
authors.initials: F
authors.lastname: Guillé
authors.forename: Dominique K
authors.initials: DK
authors.lastname: Chopin
authors.forename: Peter F A
authors.initials: PF
authors.lastname: Mulders
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Wood
authors.forename: David A
authors.initials: DA
authors.lastname: Swanson
authors.forename: Robert A
authors.initials: RA
authors.lastname: Figlin
authors.forename: Arie S
authors.initials: AS
authors.lastname: Belldegrun
authors.forename: Allan J
authors.initials: AJ
authors.lastname: Pantuck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D002648:Child; D005260:Female; D006304:Health Status; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis