title: Renal cell carcinoma in patients with end-stage renal disease: relationship between histological type and duration of dialysis.
abstract: OBJECTIVE
  To evaluate the clinical outcomes and histological types of renal cell carcinoma (RCC) arising in patients with end-stage renal disease (ESRD), and to analyse the relationship of histopathological features with the duration of dialysis.
  
  
  METHODS
  Clinical characteristics and outcomes of 34 patients who had a radical nephrectomy for RCC arising in ESRD between November 1994 and June 2008 were investigated. Archive paraffin-embedded tissue specimens obtained from 27 patients were histochemically and immunohistochemically analysed to determine the histopathological type.
  
  
  RESULTS
  There was one death from cancer and one patient with local progression within a median observation period of 29.5 months. Acquired cystic disease (ACD)-associated RCC, clear cell-papillary RCC, mucinous tubular and spindle-cell carcinoma, and Xp11.2 translocation/TFE3 gene fusion were identified in eight, two, three and one patient, respectively. Conventional clear-cell RCC was the predominant histological type (nine of 15) in patients with a duration of dialysis of <10 years, while ACD-associated RCC was predominant (seven of 12) in those with dialysis for > or =10 years. Sarcomatoid foci were identified in three patients with dialysis for > or =10 years. Papillary adenoma was microscopically identified as a satellite tumour in 10 patients.
  
  
  CONCLUSIONS
  The spectrum of histological types of RCCs arising in ESRD is distinct from that of sporadic RCCs. Patients with a longer duration of dialysis should have particular attention for progression and metastasis. Immunohistochemical profiling is efficient in the histological classification of RCCs arising in ESRD, although knowledge about genetic changes remains to be accumulated.
authors.affiliation: Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan.
authors.forename: Mohammed A A M
authors.initials: MA
authors.lastname: Nouh
authors.forename: Naoto
authors.initials: N
authors.lastname: Kuroda
authors.forename: Motoki
authors.initials: M
authors.lastname: Yamashita
authors.forename: Yushi
authors.initials: Y
authors.lastname: Hayashida
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Yano
authors.forename: Jun
authors.initials: J
authors.lastname: Minakuchi
authors.forename: Susumu
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Isaku
authors.initials: I
authors.lastname: Nomura
authors.forename: Masashi
authors.initials: M
authors.lastname: Inui
authors.forename: Mikio
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kakehi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000473:pathology* / Q000601:surgery; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D007680:Kidney Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D006435:Renal Dialysis; D013997:Time Factors