title: The subclassification of papillary renal cell carcinoma does not affect oncological outcomes after nephron sparing surgery.
abstract: OBJECTIVE
  To evaluate the oncological outcomes of papillary renal cell carcinoma (pRCC) following nephron sparing surgery (NSS) and to determine whether the subclassification type of pRCC could be a prognostic factor for recurrence, progression, and specific death.
  
  
  METHODS
  An international multicentre retrospective study involving 19 institutions and the French network for research on kidney cancer was conducted after IRB approval. We analyzed data of all patients with pRCC who were treated by NSS between 2004 and 2014.
  
  
  RESULTS
  We included 486 patients. Tumors were type 1 pRCC in 369 (76 %) cases and type 2 pRCC in 117 (24 %) cases. After a mean follow-up of 35 (1-120) months, 8 (1.6 %) patients experienced a local recurrence, 12 (1.5 %) had a metastatic progression, 24 (4.9 %) died, and 7 (1.4 %) died from cancer. Patients with type I pRCC had more grade II (66.3 vs. 46.1 %; p < 0.001) and less grade III (20 vs. 41 %; p < 0.001) tumors. Three-year estimated cancer-free survival (CFS) rate for type 1 pRCC was 96.5 % and for type 2 pRCC was 95.1 % (p = 0.894), respectively. Three-year estimated cancer-specific survival rate for type 1 pRCC was 98.4 % and for type 2 pRCC was 97.3 % (p = 0.947), respectively. Tumor stage superior to pT1 was the only prognostic factor for CFS (HR 3.5; p = 0.03).
  
  
  CONCLUSIONS
  Histological subtyping of pRCC has no impact on oncologic outcomes after nephron sparing surgery. In this selected population of pRCC tumors, we found that tumor stage is the only prognostic factor for cancer-free survival.
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France. pibigot@chu-angers.fr.|French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France. pibigot@chu-angers.fr.|Department of Urology, CHU Angers, Angers University Hospital, 4 rue Larrey, 49333, Angers, France. pibigot@chu-angers.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bigot
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Bordeaux University Hospital, Bordeaux, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Bernhard
authors.affiliation: USC Institute of Urology, University of Southern California, Los Angeles, CA, USA.
authors.forename: Inderbir S
authors.initials: IS
authors.lastname: Gill
authors.affiliation: Department of Urology, Bordeaux University Hospital, Bordeaux, France.
authors.forename: Nam Son
authors.initials: NS
authors.lastname: Vuong
authors.affiliation: French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Pontchaillou University Hospital, Rennes, France.
authors.forename: Grégory
authors.initials: G
authors.lastname: Verhoest
authors.affiliation: French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Lille University Hospital, Lille, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Flamand
authors.affiliation: Department of Urology, Lille University Hospital, Lille, France.
authors.forename: Boris
authors.initials: B
authors.lastname: Reix
authors.affiliation: Department of Urology, University Hospital of Ankara, Ankara, Turkey.
authors.forename: Evren
authors.initials: E
authors.lastname: Suer
authors.affiliation: Department of Urology, University Hospital of Ankara, Ankara, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Gökce
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Toulouse University Hospital, Toulouse, France.
authors.forename: Jean Baptiste
authors.initials: JB
authors.lastname: Beauval
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Toulouse University Hospital, Toulouse, France.
authors.forename: François Xavier
authors.initials: FX
authors.lastname: Nouhaud
authors.affiliation: Department of Urology, University Hospital of Kumamoto, Kumamoto, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Eto
authors.affiliation: Department of Urology, University Hospital of Oslo, Oslo, Norway.
authors.forename: Eduard
authors.initials: E
authors.lastname: Baco
authors.affiliation: USC Institute of Urology, University of Southern California, Los Angeles, CA, USA.
authors.forename: Toru
authors.initials: T
authors.lastname: Matsugasumi
authors.affiliation: Department of Urology, Nantes University Hospital, Nantes, France.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Chowaniec
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|Department of Urology, Nantes University Hospital, Nantes, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Rigaud
authors.affiliation: Department of Urology, Rouen University Hospital, Rouen, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Lenormand
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Toulouse University Hospital, Toulouse, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Pfister
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|Department of Urology, Clinique Jules Vernes, Nantes, France.
authors.forename: Jean François
authors.initials: JF
authors.lastname: Hetet
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|Department of Urology, Saint-Louis University Hospital, APHP, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ploussard
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|Department of Urology, La Pitié Salpetrière, APHP, Paris, France.|University Paris 6, Faculty of Medicine Pierre and Marie Curie, Paris, France.
authors.forename: Morgan
authors.initials: M
authors.lastname: Roupret
authors.affiliation: Department of Urology, La Pitié Salpetrière, APHP, Paris, France.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Léon
authors.affiliation: Department of Urology, Reims University Hospital, Reims, France.
authors.forename: Adnan El
authors.initials: AE
authors.lastname: Bakri
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|Department of Urology, Reims University Hospital, Reims, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Larré
authors.affiliation: Department of Urology, Caen University Hospital, Caen, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Tillou
authors.affiliation: Department of Urology, Caen University Hospital, Caen, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Doerfler
authors.affiliation: French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Limoges University Hospital, Limoges, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Descazeaud
authors.affiliation: Department of Urology, Dijon University Hospital, Dijon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Koutlidis
authors.affiliation: Department of Urology, Dijon University Hospital, Dijon, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Schneider
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|Department of Urology, Groupe hospitalier Diaconesses, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Sebe
authors.affiliation: Department of Urology, Bicêtre University Hospital, Le Kremlin Bicêtre, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Ingels
authors.affiliation: Department of Urology, CHU Angers, Angers University Hospital, 4 rue Larrey, 49333, Angers, France.
authors.forename: Abdel Rahmène
authors.initials: AR
authors.lastname: Azzouzi
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Toulouse University Hospital, Toulouse, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Soulié
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Méjean
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Pontchaillou University Hospital, Rennes, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Bensalah
authors.affiliation: Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.|French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.|Department of Urology, Bicêtre University Hospital, Le Kremlin Bicêtre, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
mesh_terms: D002292:Carcinoma, Renal Cell / Q000145:classification* / Q000175:diagnosis / Q000601:surgery; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D009399:Nephrons / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
keywords: Nephron sparing surgery; Oncologic outcomes; Papillary renal cell carcinoma