title: Clinical and pathological outcomes of renal cell carcinoma (RCC) in native kidneys of patients with end-stage renal disease: a long-term comparative retrospective study with RCC diagnosed in the general population.
abstract: OBJECTIVE
  Patients with end-stage renal disease (ESRD) have an increased risk of developing renal cell carcinoma (RCC). This retrospective study compared clinical and pathological outcomes of RCC occurring in native kidneys of patients with ESRD (whether they underwent kidney transplantation or not) with those of renal tumors diagnosed in the general population.
  
  
  METHODS
  The study included a total of 533 patients with RCC. The ESRD cohort included 92 patients with RCC in native kidneys. Of these, 58 and 34 cases were identified before (pre-Tx group) and after kidney transplantation (post-Tx group), respectively. The control group was composed of 441 RCCs diagnosed in the general population. Variables were compared by chi-square and Student's t tests. Cancer-specific survival was assessed by Kaplan-Meier and Cox methods.
  
  
  RESULTS
  The ESRD groups had smaller (P = 0.001), lower-grade, and lower-stage tumors than the non-ESRD group (P = 0.001). The papillary RCC rate was higher in the ESRD groups (P = 0.01). Ten-year cancer-specific survivals were 94.5, 87.9, and 74.6 % in pre-Tx, post-Tx, and non-ESRD patients, respectively (P = 0.003). Mean follow-up was 90.2 months. At multivariate analysis, tumor size (HR = 1.10), pathological stage (HR = 1.46), presence of nodal (HR = 2.22) and visceral metastases (HR = 3.49), and Fuhrman grade (HR = 1.48) were independent adverse prognostic factors for cancer-specific survival.
  
  
  CONCLUSIONS
  Native kidney RCCs arising in ESRD patients are lower stage and lower grade as compared to RCCs diagnosed in the general population, and these tumors exhibit favorable clinical and outcome features.
authors: Department of Urology, Fundació Puigvert, Universitat Autonòma de Barcelona, c/Cartagena 340-350, 08025, Barcelona, Spain, albbred@hotmail.com.
authors: Alberto
authors: A
authors: Breda
authors: Giuseppe
authors: G
authors: Lucarelli
authors: Giuseppe
authors: G
authors: Luccarelli
authors: Oscar
authors: O
authors: Rodriguez-Faba
authors: Luis
authors: L
authors: Guirado
authors: Carmen
authors: C
authors: Facundo
authors: Carlo
authors: C
authors: Bettocchi
authors: Loreto
authors: L
authors: Gesualdo
authors: Giuseppe
authors: G
authors: Castellano
authors: Giuseppe
authors: G
authors: Grandaliano
authors: Michele
authors: M
authors: Battaglia
authors: Juan
authors: J
authors: Palou
authors: Pasquale
authors: P
authors: Ditonno
authors: Humberto
authors: H
authors: Villavicencio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality* / Q000601:surgery; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009392:Nephrectomy; D012189:Retrospective Studies; D016019:Survival Analysis