Does histologic subtype affect oncologic outcomes after nephron-sparing surgery?
OBJECTIVE
To test whether renal cell carcinoma (RCC) histologic subtypes (HSs) affect cancer-specific mortality after nephron-sparing surgery (NSS). HSs are considered of prognostic value in RCC. For example, the papillary HS might confer a worse prognosis, and, at some centers, only radical nephrectomy is performed for the papillary HS.


METHODS
We used univariate and multivariate Cox regression models to study patients with Stage T1N0M0 RCC treated with NSS (n = 1205) from 1988 to 2004. The data were taken from 9 Surveillance, Epidemiology, and End Results registries.


RESULTS
At 36 months after NSS, the cancer-specific mortality rate was 97.8%, 100%, and 97.4% for a clear cell, chromophobe, and papillary RCC HS, respectively. On univariate and multivariate analyses, no statistically significant differences were recorded with regard to the HS.


CONCLUSIONS
Despite the suggested more aggressive phenotype of the papillary HS, we found no difference among the papillary, chromophobe, and clear cell variants. Thus, the diagnosis of one HS vs another HS should not deter from the use of NSS when cancer-specific mortality is considered as an endpoint.
Crépel
Maxime
M
Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada.
Isbarn
Hendrik
H
Capitanio
Umberto
U
Liberman
Daniel
D
Jeldres
Claudio
C
Sun
Maxine
M
Shariat
Shahrokh F
SF
Widmer
Hugues
H
Arjane
Philippe
P
Graefen
Markus
M
Montorsi
Francesco
F
Patard
Jean-Jacques
JJ
Perrotte
Paul
P
Karakiewicz
Pierre I
PI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000145:classification / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009399:Nephrons; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult