To evaluate and compare the outcomes of patients with localised renal cell carcinoma (RCC) with and without sarcomatoid features and the impact of this on cancer recurrence and survival.
The Canadian Kidney Cancer information system database was used to identify patients diagnosed with localised RCC between January 2011 and December 2022. Patients with pT1-T3, n Nx-N0N1, M0 stage and documented sarcomatoid status were included. Patients with sarcomatoid RCC were categorised according to the sarcomatoid component percentage (%Sarc). Inverse probability of treatment weighting scores were used to balance the groups. Cox proportional hazards models were used to assess the impact of sarcomatoid status and %Sarc on recurrence-free and overall survival.
A total of 6660 patients (201 with and 6459 without sarcomatoid features) with non-metastatic RCC were included. %Sarc data were available in 155 patients, and the median value was 10%. The weighted analysis revealed that the presence of sarcomatoid features was associated with an increased risk of developing metastasis and increased risk of mortality compared to absence of sarcomatoid features. A %Sarc value >10 was associated with an increased risk of developing metastasis and of mortality compared to a %Sarc value ≤10.
Patients with a %Sarc >10 have an increased risk of recurrence and mortality. These patients may benefit from a more stringent follow-up and %Sarc could represent an important criterion in the risk assessment for adjuvant therapy.
BJU international. 2024 Dec 04 [Epub ahead of print]
Mustafa Soytas, Alice Dragomir, Ghady Bou-Nehme Sawaya, Charles Hesswani, Maude Tanguay, Antonio Finelli, Lori Wood, Ricardo Rendon, Rahul Bansal, Aly-Khan Lalani, Daniel Y C Heng, Bimal Bhindi, Naveen S Basappa, Lucas Dean, Alan So, Jasmir G Nayak, Georg Bjarnason, Rodney Breau, Luke Lavallee, Jean-Baptiste Lattouf, Frederic Pouliot, Michael Bonert, Simon Tanguay
Division of Urology, Department of Surgery, McGill University, Montréal, Quebec, Canada., Department of Surgery, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada., Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada., Queen Elizabeth II Health Sciences Center, Dalhousie University, Halifax, Nova Scotia, Canada., Division of Urology, Dalhousie University, Halifax, Nova Scotia, Canada., Division of Urology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada., Division of Medical Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada., Division of Oncology, University of Calgary, Calgary, Alberta, Canada., Division of Urology, University of Calgary, Calgary, Alberta, Canada., Division of Medical Oncology, Alberta Health Services, Edmonton, Alberta, Canada., Division of Urology, Alberta Health Services, Edmonton, Alberta, Canada., Department of Urologic Sciences, University of British Colombia, Vancouver, British Columbia, Canada., Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada., Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada., Division of Urology, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada., Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada., Division of Urology, Université Laval, Montréal, Quebec, Canada., Division of Anatomical Pathology, St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, Ontario, Canada.