Cytogenetic profile predicts prognosis of patients with clear cell renal cell carcinoma.
OBJECTIVE
The majority of cytogenetic studies in renal cell carcinoma (RCC) have been impaired by small sample size, retrospective character, and lack of a survival end point. We prospectively studied the prognostic impact of cytogenetic abnormalities on a larger cohort of patients having up to 108 months of follow-up.


METHODS
Tumors of 282 patients who underwent nephrectomy for clear cell RCC were cytogenetically analyzed. Results were correlated with pathological factors and disease-specific survival.


RESULTS
The most frequently observed cytogenetic abnormalities were loss of 3p (60%), gain of 5q (33%), loss of 14q (28%), trisomy 7 (26%), loss of 8p (20%), loss of 6q (17%), loss of 9p (16%), loss of 4p (13%), and loss of chromosome Y in men (55%). Tumors with loss of 3p presented at lower TNM stages. Loss of 4p, 9p, and 14q were all associated with higher TNM stages, higher grade, and greater tumor size. A deletion of 3p was associated with better prognosis (P = .03), while loss of 4p (P < .001), loss of 9p (P < .01), and loss of 14q (P < .01) were each associated with worse prognosis. Loss of the Y chromosome led to improved progression-free survival in metastatic patients (P = .02). In multivariate analysis, loss of 9p was retained as an independent prognostic factor.


CONCLUSIONS
This cytogenetic study serves as a proof of principal that genetic information, such as loss of chromosome 9, can be obtained from widely available technology, and can provide additional prognostic information to standard clinicopathologic variables.
Klatte
Tobias
T
Department of Urology, David Geffen School of Medicine at UCLA, Center for Health Sciences, Los Angeles, CA 90025-1738, USA.
Rao
P Nagesh
PN
de Martino
Michela
M
LaRochelle
Jeffrey
J
Shuch
Brian
B
Zomorodian
Nazy
N
Said
Jonathan
J
Kabbinavar
Fairooz F
FF
Belldegrun
Arie S
AS
Pantuck
Allan J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000235:genetics* / Q000401:mortality*; D002872:Chromosome Deletion; D002883:Chromosomes, Human, Pair 14; D002893:Chromosomes, Human, Pair 3; D002894:Chromosomes, Human, Pair 4; D002895:Chromosomes, Human, Pair 5; D002896:Chromosomes, Human, Pair 6; D002897:Chromosomes, Human, Pair 7; D002898:Chromosomes, Human, Pair 8; D002899:Chromosomes, Human, Pair 9; D005260:Female; D006801:Humans; D007621:Karyotyping; D007680:Kidney Neoplasms / Q000235:genetics* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012729:Sex Chromosome Aberrations; D014314:Trisomy