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World Journal of Urology

, Volume 33, Issue 1, pp 1–7 | Cite as

Clinical and pathological outcomes of renal cell carcinoma (RCC) in native kidneys of patients with end-stage renal disease: a long-term comparative retrospective study with RCC diagnosed in the general population

  • Alberto BredaEmail author
  • Giuseppe LuccarelliEmail author
  • Oscar Rodriguez-Faba
  • Luis Guirado
  • Carmen Facundo
  • Carlo Bettocchi
  • Loreto Gesualdo
  • Giuseppe Castellano
  • Giuseppe Grandaliano
  • Michele Battaglia
  • Juan Palou
  • Pasquale Ditonno
  • Humberto Villavicencio
Original Article

Abstract

Purpose

Patients with end-stage renal disease (ESRD) have an increased risk of developing renal cell carcinoma (RCC). This retrospective study compared clinical and pathological outcomes of RCC occurring in native kidneys of patients with ESRD (whether they underwent kidney transplantation or not) with those of renal tumors diagnosed in the general population.

Methods

The study included a total of 533 patients with RCC. The ESRD cohort included 92 patients with RCC in native kidneys. Of these, 58 and 34 cases were identified before (pre-Tx group) and after kidney transplantation (post-Tx group), respectively. The control group was composed of 441 RCCs diagnosed in the general population. Variables were compared by chi-square and Student’s t tests. Cancer-specific survival was assessed by Kaplan–Meier and Cox methods.

Results

The ESRD groups had smaller (P = 0.001), lower-grade, and lower-stage tumors than the non-ESRD group (P = 0.001). The papillary RCC rate was higher in the ESRD groups (P = 0.01). Ten-year cancer-specific survivals were 94.5, 87.9, and 74.6 % in pre-Tx, post-Tx, and non-ESRD patients, respectively (P = 0.003). Mean follow-up was 90.2 months. At multivariate analysis, tumor size (HR = 1.10), pathological stage (HR = 1.46), presence of nodal (HR = 2.22) and visceral metastases (HR = 3.49), and Fuhrman grade (HR = 1.48) were independent adverse prognostic factors for cancer-specific survival.

Conclusions

Native kidney RCCs arising in ESRD patients are lower stage and lower grade as compared to RCCs diagnosed in the general population, and these tumors exhibit favorable clinical and outcome features.

Keywords

Renal cell carcinoma Renal transplantation Nephrectomy End-stage renal disease Prognosis Pathology 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Alberto Breda
    • 1
    Email author
  • Giuseppe Luccarelli
    • 1
    • 2
    Email author
  • Oscar Rodriguez-Faba
    • 1
  • Luis Guirado
    • 3
  • Carmen Facundo
    • 3
  • Carlo Bettocchi
    • 2
  • Loreto Gesualdo
    • 4
  • Giuseppe Castellano
    • 4
  • Giuseppe Grandaliano
    • 4
  • Michele Battaglia
    • 2
  • Juan Palou
    • 1
  • Pasquale Ditonno
    • 2
  • Humberto Villavicencio
    • 1
  1. 1.Department of Urology, Fundació PuigvertUniversitat Autonòma de BarcelonaBarcelonaSpain
  2. 2.Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ TransplantationUniversity of BariBariItaly
  3. 3.Department of Nephrology, Fundació PuigvertUniversitat Autonòma de BarcelonaBarcelonaSpain
  4. 4.Dialysis and Transplantation Unit, Department of Emergency and Organ TransplantationNephrology, University of BariBariItaly

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