BACKGROUND - It is controversial whether chromophobe renal cell carcinoma (chRCC) or clear cell renal cell carcinoma (ccRCC) is associated with better survival. We conducted a clinical-based cohort study and meta-analysis to evaluate the prognostic role of histology between chRCC and ccRCC.
METHODS - A cohort of 1540 patients (166 with chRCC and 1374 with ccRCC) were selected from Sun Yat-sen University and The Cancer Genome Atlas databases. The clinicopathological parameters and overall survival (OS) were compared between patients with chRCC and those with ccRCC. For the meta-analysis, we searched the PubMed, Cochrane Library, and Ovid databases for studies comparing OS or cancer-specific survival (CSS) between chRCC and ccRCC.
RESULTS - The cohort study revealed that patients with chRCC were younger (median 52 vs. 55 years, P < 0. 001), were more commonly female (47. 0 vs. 33. 0 %, P < 0. 001), and had a larger tumor size (mean 7. 1 vs. 5. 9 cm, P < 0. 001), and they had a lower stage compared with those with ccRCC. Five-year OS rates for chRCC and ccRCC were 90. 3 and 75. 3 %, respectively (P < 0. 001). We found significantly better survival for chRCC in stratification analysis by age, sex, tumor size, and stage. Similar results were observed on both univariate [hazard ratio (HR), 0. 30; 95 % confidence interval (CI) 0. 16-0. 55, P < 0. 001] and multivariate analyses (HR 0. 42; 95 % CI 0. 23-0. 79, P = 0. 006). Ten studies were included in our meta-analysis. Eight of them provided data on univariate analysis. The pooled HR was statistically significant for OS (pooled HR 0. 49; 95 % CI 0. 30-0. 79, P = 0. 004) and CSS (pooled HR 0. 49; 95 % CI 0. 37-0. 64, P < 0. 001). Seven studies reported the HR on multivariate analysis. The pooled HR was also statistically significant for OS (pooled HR 0. 63; 95 % CI 0. 51-0. 77, P < 0. 001) and CSS (pooled HR 0. 72; 95 % CI 0. 57-0. 90, P = 0. 003). These data indicate that patients with chRCC had better outcomes than those with ccRCC.
CONCLUSIONS - Our large cohort study and meta-analysis confirmed that chRCC had better survival than ccRCC.
International urology and nephrology. 2015 Nov 20 [Epub ahead of print]
Hui-Ming Jiang, Jin-Huan Wei, Zhi-Ling Zhang, Yong Fang, Bang-Fen Zhou, Zhen-Hua Chen, Jun Lu, Bing Liao, Fang-Jian Zhou, Jun-Hang Luo, Wei Chen
Department of Urology, First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. , Department of Urology, First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. , Department of Urology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China. , Department of Urology, First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. , Department of Urology, First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. , Department of Urology, First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. , Department of Urology, First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. , Department of Urology, First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. , Department of Urology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China. , Department of Urology, First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. Department of Urology, First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China.