There is no definitive evidence of the prognosis impact of histological variants (HVs) in patients who undergo surgical resection of a nonmetastatic renal cell carcinoma (nm-RCC) with venous tumor thrombus (TT).
To investigate the impact of HVs on the prognosis of patients with nm-RCC with TT after radical surgery.
Patients who underwent radical nephrectomy with the removal of the venous TT for an nm-RCC were included in a retrospective study.
Three groups were identified: clear cell (ccRCC), papillary (pRCC), and chromophobe (chRCC) RCC. The primary outcome measures (disease-free and overall survival [OS]) were assessed using the Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate Cox proportional hazard models were used to study the impact of HVs on survival.
A total of 873 patients were included. The histological subtypes were distributed as follows: ccRCC in 780 cases, pRCC in 58 cases, and chRCC in 35 cases. At the time of data analysis, 612 patients were recurrence free and 228 had died. A survival analysis revealed significant differences in both OS and recurrence-free survival across histological subtypes, with the poorest outcomes observed in pRCC patients (p < 0.05). In a multivariable analysis, pRCC was independently associated with worse disease-free survival and OS (hazard ratio [HR]: 1.71; p = 0.01 and HR: 1.24; p = 0.04), while chRCC was associated with more favorable outcomes than ccRCC (HR: 0.05; p < 0.001 and HR: 0.02; p < 0.001). A limitation of the study is its retrospective nature.
In this multicentric series, HVs appeared to impact the medium-term oncological prognosis of kidney cancer with TT.
This study investigated the differences in oncological outcomes among histological variants (clear cell, papillary, and chromophobe) in a cohort of nonmetastatic renal cell carcinoma patients with venous tumor thrombus extension. We observed that these histological variants within this specific subgroup exhibit distinct outcomes, with papillary renal cell carcinoma being associated with the worst prognosis.
European urology open science. 2024 Mar 08*** epublish ***
Raphael Fleury, Théophile Bertail, Karim Bensalah, Jean-Christophe Bernhard, Francois Audenet, Thibaut Waeckel, Bastien Parier, Cécile Champy, Jonathan Olivier, Nicolas Doumerc, Thibault Tricard, Nicolas Branger, Franck Bruyere, Paul Neuville, Louis Surlemont, Jean Alexandre Long, Alexis Fontenil, Maxime Vallee, Morgan Roupret, Romain Boissier, Jean Jacques Patard, Mathieu Durand, Idir Ouzaid, Benjamin Rouget, Xavier Durand, Charlotte Joncour, Olivier Belas, Florie Denise Gomez, Pierre Bigot, Zine-Eddine Khene, members of the French Committee of Urologic Oncology CCAFU
Department of Urology, Centre Hospitalier Universitaire de Rennes, Rennes, France., Department of Urology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France., Department of Urology, Hôpital Européen Georges Pompidou, APHP, Paris, France., Department of Urology, Centre Hospitalier Universitaire de Caen, Caen, France., Department of Urology, Hôpital Bicêtre, APHP, Paris, France., Department of Urology, Centre Hospitalier Henri Mondor, APHP, Créteil, France., Department of urology, Centre Hospitalier Universitaire de Lille, Lille, France., Department of Urology, Centre Hospitalier Universitaire Rangueil, Toulouse, France., Department of Urology, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France., Department of Urology, Institut Paoli Calmettes de Marseille, Marseille, France., Department of Urology, Centre Hospitalier Universitaire de Tours, Tours, France., Department of Urology, Hospices Civils de Lyon, Lyon, France., Department of Urology, Centre Hospitalier Universitaire de Rouen, Rouen, France., Department of Urology, Centre Hospitalier Universitaire de Grenoble, Grenoble, France., Department of Urology, Centre Hospitalier Universitaire de Nîmes, Nîmes, France., Department of Urology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France., Department of Urology, Hôpital de la Pitié Salpêtrière, APHP, Paris, France., Department of Urology, Hôpital de la Conception, APHM, Marseille, France., Department of Urology, Centre Hospitalier de Mont-de-Marsan, Mont-de-Marsan, France., Department of Urology, Centre Hospitalier Universitaire de Nice, Nice, France., Department of Urology, Hôpital Bichat, APHP, Paris, France., Department of Urology, Centre Hospitalier de Libourne, Libourne, France., Department of Urology, Hôpital Privé Saint Joseph, Paris, France., Department of Urology, Centre Hospitalier Universitaire de Reims, Reims, France., Department of Urology, Pôle Santé Sud au Mans, Le Mans, France., Department of Urology, Hôpital Tenon, APHP, Paris, France., Department of Urology, Centre Hospitalier Universitaire d'Angers, d'Angers, France.