title: Significance of chromosome 9p status in renal cell carcinoma: a systematic review and quality of the reported studies.
abstract: Defining the prognosis of renal cell carcinoma (RCC) using genetic tests is an evolving area. The prognostic significance of 9p status in RCC, although described in the literature, remains underutilised in clinical practice. The study explored the causes of this translational gap. A systematic review on the significance of 9p status in RCC was performed to assess its clinical applicability and impact on clinical decision-making. Medline, Embase, and other electronic searches were made for studies reporting on 9p status in RCC. We collected data on: genetic techniques, pathological parameters, clinical outcomes, and completeness of follow-up assessment. Eleven studies reporting on 1,431 patients using different genetic techniques were included. The most commonly used genetic technique for the assessment of 9p status in RCC was fluorescence in situ hybridization. Combined genomic hybridisation (CGH), microsatellite analysis, karyotyping, and sequencing were other reported techniques. Various thresholds and cut-off values were used for the diagnosis of 9p deletion in different studies. Standardization, interobserver agreement, and consensus on the interpretation of test remained poor. The studies lacked validation and had high risk of bias and poor clinical applicability as assessed by two independent reviewers using a modified quality assessment tool. Further protocol driven studies with standardised methodology including use of appropriate positive and negative controls, assessment of interobserver variations, and evidenced based follow-up protocols are needed to clarify the role of 9p status in predicting oncological outcomes in renal cell cancer.
authors.affiliation: Academic Section of Urology, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK.
authors.forename: Ismail
authors.identifier: 0000-0002-1511-8314
authors.initials: I
authors.lastname: El-Mokadem
authors.affiliation: Academic Section of Urology, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK.
authors.forename: John
authors.initials: J
authors.lastname: Fitzpatrick
authors.affiliation: Academic Section of Urology, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK.
authors.forename: Bhavan
authors.initials: B
authors.lastname: Rai
authors.affiliation: Department of Cytogenetics, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK.
authors.forename: J
authors.initials: J
authors.lastname: Cunningham
authors.affiliation: Department of Cytogenetics, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK.
authors.forename: Norman
authors.initials: N
authors.lastname: Pratt
authors.affiliation: Department of Pathology, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK.
authors.forename: Stewart
authors.initials: S
authors.lastname: Fleming
authors.affiliation: Academic Section of Urology, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK ; Division of Imaging and Technology, Medical Research Institute, Medical School, University of Dundee, Dundee DD1 9SY, UK.
authors.forename: Ghulam
authors.initials: G
authors.lastname: Nabi
mesh_terms: D002292:Carcinoma, Renal Cell / Q000235:genetics*; D002899:Chromosomes, Human, Pair 9 / Q000235:genetics*; D005260:Female; D060005:Genotyping Techniques / Q000379:methods* / Q000592:standards*; D006801:Humans; D007680:Kidney Neoplasms / Q000235:genetics*; D016239:MEDLINE; D008297:Male; D015588:Observer Variation; D017410:Practice Guidelines as Topic