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World Journal of Urology

, Volume 34, Issue 3, pp 347–352 | Cite as

The subclassification of papillary renal cell carcinoma does not affect oncological outcomes after nephron sparing surgery

  • Pierre Bigot
  • Jean-Christophe Bernhard
  • Inderbir S. Gill
  • Nam Son Vuong
  • Grégory Verhoest
  • Vincent Flamand
  • Boris Reix
  • Evren Suer
  • Ilker Gökce
  • Jean Baptiste Beauval
  • François Xavier Nouhaud
  • Masatoshi Eto
  • Eduard Baco
  • Toru Matsugasumi
  • Yvonne Chowaniec
  • Jérôme Rigaud
  • Claire Lenormand
  • Christian Pfister
  • Jean François Hetet
  • Guillaume Ploussard
  • Morgan Roupret
  • Priscilla Léon
  • Adnan El Bakri
  • Stéphane Larré
  • Xavier Tillou
  • Arnaud Doerfler
  • Aurélien Descazeaud
  • Nicolas Koutlidis
  • Alexandre Schneider
  • Philippe Sebe
  • Alexandre Ingels
  • Abdel Rahmène Azzouzi
  • Michel Soulié
  • Arnaud Méjean
  • Karim Bensalah
  • Jean-Jacques Patard
  • the members of the Kidney Cancer group of the CCAFU
Original Article

Abstract

Objectives

To evaluate the oncological outcomes of papillary renal cell carcinoma (pRCC) following nephron sparing surgery (NSS) and to determine whether the subclassification type of pRCC could be a prognostic factor for recurrence, progression, and specific death.

Materials and methods

An international multicentre retrospective study involving 19 institutions and the French network for research on kidney cancer was conducted after IRB approval. We analyzed data of all patients with pRCC who were treated by NSS between 2004 and 2014.

Results

We included 486 patients. Tumors were type 1 pRCC in 369 (76 %) cases and type 2 pRCC in 117 (24 %) cases. After a mean follow-up of 35 (1–120) months, 8 (1.6 %) patients experienced a local recurrence, 12 (1.5 %) had a metastatic progression, 24 (4.9 %) died, and 7 (1.4 %) died from cancer. Patients with type I pRCC had more grade II (66.3 vs. 46.1 %; p < 0.001) and less grade III (20 vs. 41 %; p < 0.001) tumors. Three-year estimated cancer-free survival (CFS) rate for type 1 pRCC was 96.5 % and for type 2 pRCC was 95.1 % (p = 0.894), respectively. Three-year estimated cancer-specific survival rate for type 1 pRCC was 98.4 % and for type 2 pRCC was 97.3 % (p = 0.947), respectively. Tumor stage superior to pT1 was the only prognostic factor for CFS (HR 3.5; p = 0.03).

Conclusion

Histological subtyping of pRCC has no impact on oncologic outcomes after nephron sparing surgery. In this selected population of pRCC tumors, we found that tumor stage is the only prognostic factor for cancer-free survival.

Keywords

Nephron sparing surgery Papillary renal cell carcinoma Oncologic outcomes 

Notes

Compliance with Ethical Standards

Ethical standard

This retrospective study was performed after approval from each institutional review board.

Conflict of interest

All other authors state that they have no conflicts of interest that are directly or indirectly related to the research.

References

  1. 1.
    Patard JJ et al (2005) Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol 23(12):2763–2771CrossRefPubMedGoogle Scholar
  2. 2.
    Mancilla-Jimenez R, Stanley RJ, Blath RA (1976) Papillary renal cell carcinoma: a clinical, radiologic, and pathologic study of 34 cases. Cancer 38(6):2469–2480CrossRefPubMedGoogle Scholar
  3. 3.
    Amin MB et al (2002) Prognostic impact of histologic subtyping of adult renal epithelial neoplasms: an experience of 405 cases. Am J Surg Pathol 26(3):281–291CrossRefPubMedGoogle Scholar
  4. 4.
    Pignot G et al (2007) Survival analysis of 130 patients with papillary renal cell carcinoma: prognostic utility of type 1 and type 2 subclassification. Urology 69(2):230–235CrossRefPubMedGoogle Scholar
  5. 5.
    Delahunt B, Eble JN (1997) Papillary renal cell carcinoma: a clinicopathologic and immunohistochemical study of 105 tumors. Mod Pathol 10(6):537–544PubMedGoogle Scholar
  6. 6.
    Sibony M, Vieillefond A (2008) Non clear cell renal cell carcinoma. 2008 update in renal tumor pathology. Ann Pathol 28(5):381–401CrossRefPubMedGoogle Scholar
  7. 7.
    Amin MB et al (1997) Papillary (chromophil) renal cell carcinoma: histomorphologic characteristics and evaluation of conventional pathologic prognostic parameters in 62 cases. Am J Surg Pathol 21(6):621–635CrossRefPubMedGoogle Scholar
  8. 8.
    Beck SD et al (2004) Effect of papillary and chromophobe cell type on disease-free survival after nephrectomy for renal cell carcinoma. Ann Surg Oncol 11(1):71–77CrossRefPubMedGoogle Scholar
  9. 9.
    Chow GK, Myles J, Novick AC (2001) The Cleveland Clinic experience with papillary (chromophil) renal cell carcinoma: clinical outcome with histopathological correlation. Can J Urol 8(2):1223–1228PubMedGoogle Scholar
  10. 10.
    Delahunt B et al (2001) Morphologic typing of papillary renal cell carcinoma: comparison of growth kinetics and patient survival in 66 cases. Hum Pathol 32(6):590–595CrossRefPubMedGoogle Scholar
  11. 11.
    Huang WC et al (2006) Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 7(9):735–740PubMedCentralCrossRefPubMedGoogle Scholar
  12. 12.
    Sun M et al (2012) A non-cancer-related survival benefit is associated with partial nephrectomy. Eur Urol 61(4): 725–731CrossRefPubMedGoogle Scholar
  13. 13.
    Kaushik D, Kim SP, Childs MA et al (2013) Overall survival and development of stage IV chronic kidney disease in patients undergoing partial and radical nephrectomy for benign renal tumors. Eur Urol 64(4):600–606CrossRefPubMedGoogle Scholar
  14. 14.
    Tan HJ et al (2012) Long-term survival following partial vs radical nephrectomy among older patients with early-stage kidney cancer. JAMA 307(15):1629–1635CrossRefPubMedGoogle Scholar
  15. 15.
    Bigot P et al (2010) How radical nephrectomy compares to partial nephrectomy for the treatment of pT1a papillary renal cell carcinomas? Prog Urol 20(5):350–355CrossRefPubMedGoogle Scholar
  16. 16.
    Crepel M et al (2009) Does histologic subtype affect oncologic outcomes after nephron-sparing surgery? Urology 74(4):842–845CrossRefPubMedGoogle Scholar
  17. 17.
    Sobin LH, Gospodarowicz M, Wittekind C (eds) (2009) TNM classification of malignant tumors. UICC International Union Against Cancer, 7th edn. Wiley-Blackwell, New York, pp 255–257Google Scholar
  18. 18.
    Mejean A et al (2003) Prognostic factors for the survival of patients with papillary renal cell carcinoma: meaning of histological typing and multifocality. J Urol 170(3):764–767CrossRefPubMedGoogle Scholar
  19. 19.
    Krejci KG et al (2003) Nephron-sparing surgery for renal cell carcinoma: clinicopathologic features predictive of patient outcome. Urology 62(4):641–646CrossRefPubMedGoogle Scholar
  20. 20.
    Steinestel J et al (2014) Positive surgical margins in nephron-sparing surgery: risk factors and therapeutic consequences. World J Surg Oncol 12:252PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Kwon EO et al (2007) Impact of positive surgical margins in patients undergoing partial nephrectomy for renal cortical tumours. BJU Int 99(2):286–289CrossRefPubMedGoogle Scholar
  22. 22.
    Bensalah K et al (2010) Positive surgical margin appears to have negligible impact on survival of renal cell carcinomas treated by nephron-sparing surgery. Eur Urol 57(3):466–471CrossRefPubMedGoogle Scholar
  23. 23.
    Bernhard JC et al (2010) Predictive factors for ipsilateral recurrence after nephron-sparing surgery in renal cell carcinoma. Eur Urol 57(6):1080–1086CrossRefPubMedGoogle Scholar
  24. 24.
    Dimarco DS et al (2004) Long-term survival of patients with unilateral sporadic multifocal renal cell carcinoma according to histologic subtype compared with patients with solitary tumors after radical nephrectomy. Urology 64(3):462–467CrossRefPubMedGoogle Scholar
  25. 25.
    Gorin MA et al (2013) Outcomes and predictors of clinical T1 to pathological T3a tumor up-staging after robotic partial nephrectomy: a multi-institutional analysis. J Urol 190(5):1907–1911CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Pierre Bigot
    • 1
    • 2
    • 3
  • Jean-Christophe Bernhard
    • 1
    • 2
    • 4
  • Inderbir S. Gill
    • 5
  • Nam Son Vuong
    • 4
  • Grégory Verhoest
    • 2
    • 6
  • Vincent Flamand
    • 2
    • 7
  • Boris Reix
    • 7
  • Evren Suer
    • 8
  • Ilker Gökce
    • 8
  • Jean Baptiste Beauval
    • 1
    • 2
    • 9
  • François Xavier Nouhaud
    • 1
    • 2
    • 9
  • Masatoshi Eto
    • 10
  • Eduard Baco
    • 11
  • Toru Matsugasumi
    • 5
  • Yvonne Chowaniec
    • 12
  • Jérôme Rigaud
    • 1
    • 12
  • Claire Lenormand
    • 13
  • Christian Pfister
    • 1
    • 2
    • 9
  • Jean François Hetet
    • 1
    • 14
  • Guillaume Ploussard
    • 1
    • 15
  • Morgan Roupret
    • 1
    • 16
    • 17
  • Priscilla Léon
    • 16
  • Adnan El Bakri
    • 18
  • Stéphane Larré
    • 1
    • 18
  • Xavier Tillou
    • 19
  • Arnaud Doerfler
    • 19
  • Aurélien Descazeaud
    • 2
    • 20
  • Nicolas Koutlidis
    • 21
  • Alexandre Schneider
    • 21
  • Philippe Sebe
    • 1
    • 22
  • Alexandre Ingels
    • 23
  • Abdel Rahmène Azzouzi
    • 3
  • Michel Soulié
    • 1
    • 2
    • 9
  • Arnaud Méjean
    • 1
    • 2
    • 24
  • Karim Bensalah
    • 1
    • 2
    • 6
  • Jean-Jacques Patard
    • 1
    • 2
    • 23
  • the members of the Kidney Cancer group of the CCAFU
  1. 1.Cancerology Committee of the French Association of Urology (CCAFU)ParisFrance
  2. 2.French Network for Research on Kidney Cancer (UroCCR)BordeauxFrance
  3. 3.Department of Urology, CHU AngersAngers University HospitalAngersFrance
  4. 4.Department of UrologyBordeaux University HospitalBordeauxFrance
  5. 5.USC Institute of UrologyUniversity of Southern CaliforniaLos AngelesUSA
  6. 6.Department of UrologyPontchaillou University HospitalRennesFrance
  7. 7.Department of UrologyLille University HospitalLilleFrance
  8. 8.Department of UrologyUniversity Hospital of AnkaraAnkaraTurkey
  9. 9.Department of UrologyToulouse University HospitalToulouseFrance
  10. 10.Department of UrologyUniversity Hospital of KumamotoKumamotoJapan
  11. 11.Department of UrologyUniversity Hospital of OsloOsloNorway
  12. 12.Department of UrologyNantes University HospitalNantesFrance
  13. 13.Department of UrologyRouen University HospitalRouenFrance
  14. 14.Department of UrologyClinique Jules VernesNantesFrance
  15. 15.Department of UrologySaint-Louis University Hospital, APHPParisFrance
  16. 16.Department of UrologyLa Pitié Salpetrière, APHPParisFrance
  17. 17.University Paris 6, Faculty of Medicine Pierre and Marie CurieParisFrance
  18. 18.Department of UrologyReims University HospitalReimsFrance
  19. 19.Department of UrologyCaen University HospitalCaenFrance
  20. 20.Department of UrologyLimoges University HospitalLimogesFrance
  21. 21.Department of UrologyDijon University HospitalDijonFrance
  22. 22.Department of UrologyGroupe hospitalier DiaconessesParisFrance
  23. 23.Department of UrologyBicêtre University HospitalLe Kremlin BicêtreFrance
  24. 24.Department of UrologyHôpital Européen Georges Pompidou, AP-HPParisFrance

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