title: Clinically localized type 1 and 2 papillary renal cell carcinomas have similar survival outcomes following surgery.
abstract: OBJECTIVE
  We aimed to determine incidence, pathologic findings, prognostic factors and clinical outcomes for patients with clinically localized papillary RCC.
  
  
  METHODS
  Demographic, clinical and pathologic findings were collected on all patients with PRCC undergoing surgery at four academic medical centers. The primary endpoint was cancer-specific survival (CSS). Relapse-free survival (RFS) and overall survival (OS) were secondary endpoints. Kaplan-Meier estimates were obtained, and Cox proportional hazard regression models were used to assess predictors of mortality and relapse.
  
  
  RESULTS
  We identified 626 PRCC, of which 373 (60 %) were type 1 and 253 (40 %) were type 2, with three-quarters of all tumors being pT1. Compared to patients with type 1, those with type 2 were older (mean age: 63 vs 61; p = 0.02), presented more commonly with symptoms (13 vs 7 %; p = 0.02) and had larger mean tumor size (5.2 vs 4.3 cm; p = 0.001). With a median follow-up of 41 months (IQR: 16-68), 92 patients had died of PRCC (15 %), 48 (8 %) experienced relapse, and 101 died from all causes (16 %). The estimated 5-year CSS, RFS and OS were 83, 91 and 82 %, respectively. In multivariable analysis, older age, T stage and nodal status were predictors of CSS and OS. However, PRCC subtype was not a predictor of CSS, RFS or OS.
  
  
  CONCLUSIONS
  While patients with type 2 PRCC appear to present with more advanced disease than patients with type 1, PRCC subtype does not appear to be an independent predictor of CSS, RFS or OS for treated localized disease.
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC6038, J-664, Chicago, IL, 60637, USA. rodrigoledezma@gmail.com.
authors.forename: Rodrigo A
authors.initials: RA
authors.lastname: Ledezma
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC6038, J-664, Chicago, IL, 60637, USA.
authors.forename: Edris
authors.initials: E
authors.lastname: Negron
authors.affiliation: Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Gladell P
authors.initials: GP
authors.lastname: Paner
authors.affiliation: Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Rjepaj
authors.affiliation: Department of Urology, Columbia University, New York, NY, USA.
authors.forename: Danny
authors.initials: D
authors.lastname: Lascano
authors.affiliation: Division of Urologic Oncology, Fox Chase Cancer Center Temple University Health System, Philadelphia, PA, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Haseebuddin
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC6038, J-664, Chicago, IL, 60637, USA.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Dangle
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC6038, J-664, Chicago, IL, 60637, USA.
authors.forename: Arieh L
authors.initials: AL
authors.lastname: Shalhav
authors.affiliation: Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Crist
authors.affiliation: Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
authors.forename: Jay D
authors.initials: JD
authors.lastname: Raman
authors.affiliation: Department of Urology, Columbia University, New York, NY, USA.
authors.forename: G
authors.initials: G
authors.lastname: Joel DeCastro
authors.affiliation: Department of Pathology, Columbia University, New York, NY, USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Harik
authors.affiliation: Department of Pathology, Columbia University, New York, NY, USA.
authors.forename: Monika
authors.initials: M
authors.lastname: Paroder
authors.affiliation: Division of Urologic Oncology, Fox Chase Cancer Center Temple University Health System, Philadelphia, PA, USA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Uzzo
authors.affiliation: Division of Urologic Oncology, Fox Chase Cancer Center Temple University Health System, Philadelphia, PA, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kutikov
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC6038, J-664, Chicago, IL, 60637, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Eggener
mesh_terms: D002292:Carcinoma, Renal Cell / Q000145:classification / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Histological type; Papillary RCC; Prognosis; Survival