The authors analyzed 5,378 patients with kidney cancer from 16 academic centers within the SATURN project (Surveillance And Treatment Update Renal Neoplasms). The aim was to investigate the impact of histologic subtype on recurrence-free survival (RFS) and cancer-specific survival (CSS). 81% of patients had clear cell subtype, 11% papillary subtype, 6% chromophobe subtype, 1% collecting duct subtype and 2% of patients had unclassified tumors. At a median follow-up of 42 months, 20% of patients experienced tumor recurrence, 15% of patients had died from kidney cancer and 6.2% of patients from other causes. On multivariate analysis, the hazard ratios (HR) for RFS were 1 for clear cell subtype, 0.7 for papillary subtype, 0.6 for chromophobe subtype, 2.4 for collecting duct subtype and 1.7 for unclassified tumors. The HRs for CSS were 1, 0.7, 0.6, 2.5 and 1.4, respectively. The authors concluded that histologic subtypes are independent predictors of RFS and CSS. Including these factors into prognostic systems resulted, however, only in marginal increase of prognostic accuracy of 0.2% for RFS and 0.01% for CSS.
The results that papillary and chromophobe subtypes are associated with better outcome compared to the clear cell subtype, and that collecting duct subtype as well as unclassified tumor perform worse confirm published literature.
Presented by Giacomo Novara, MD, FEBU, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria
Reported for UroToday by Christian Doehn, MD, PhD, Department of Urology, University of Lübeck Medical School, Lübeck Germany.
View EAU 2011 Annual Meeting Coverage
