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Comparison of survival outcomes in patients with metastatic papillary vs. clear-cell renal cell carcinoma: a propensity-score analysis

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World Journal of Urology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 12 August 2020

Abstract

Background

To compare survival outcomes of metastatic patients harbouring either papillary (pRCC) or clear-cell (ccRCC) renal cell carcinoma in overall population and according to treatment modality.

Methods

Within the Surveillance, Epidemiology and End Results database (2006–2015), we identified 6800 patients (585 papillary and 6215 clear-cell) with metastatic RCC. Propensity-score (PS) matching, Kaplan–Meier plots and multivariable Cox-regression models (CRMs) were used.

Results

Overall, 585 (8.6%) patients harboured pRCC. Rates of nodal metastases were higher in patients with pRCC (49.7 vs. 23.3%; p < 0.001). Median overall survival (OS) was 13 vs. 18 months for pRCC vs. ccRCC patients. After multivariable adjustments, no difference in OS was recorded. Furthermore, after propensity-score matching, virtually the same results were recorded. Median OS of pRCC vs. ccRCC was 8 vs. 4 months for no treatment (NT), 11 vs. 12 months for targeted therapy alone (TT), 17 vs. 35 months for cytoreductive nephrectomy alone (CN) and 18 vs. 25 months for combination of CN with TT.

Conclusions

Metastatic pRCC patients exhibit poor survival, regardless of treatment received. Moreover, pRCC patients are more likely to present nodal metastases, compared to ccRCC patients, as demonstrated by twofold higher rates of lymph node invasion at diagnosis. These observations indicate that papillary variant represents more prognostically unfavorable tumor histology, in the context of metastatic RCC.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada

    Giuseppe Rosiello, Carlotta Palumbo, Sophie Knipper, Angela Pecoraro, Stefano Luzzago, Pierre-Antoine St-Hilaire, Zhe Tian, Fred Saad & Pierre I. Karakiewicz

  2. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy

    Giuseppe Rosiello, Umberto Capitanio, Francesco Montorsi & Alberto Briganti

  3. Urology Unit, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy

    Carlotta Palumbo

  4. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Sophie Knipper

  5. Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy

    Angela Pecoraro

  6. Department of Urology, European Institute of Oncology, Milan, Italy

    Stefano Luzzago

  7. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

    Shahrokh F. Shariat

  8. Institute of Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

    Shahrokh F. Shariat

Authors
  1. Giuseppe Rosiello
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  2. Carlotta Palumbo
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  11. Fred Saad
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  13. Pierre I. Karakiewicz
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Contributions

GR: Project development, data collection, data analyses, manuscript writing; CP: Data collection, manuscript editing; SK: Data collection, manuscript editing; AP: Data collection, manuscript editing; SL: Data collection, manuscript editing; PASH: Data collection, manuscript editing; ZT: Data analyses; UC: Manuscript editing; FM: Manuscript editing; SFS: Manuscript editing; FS: Manuscript editing; AB: Manuscript editing; PIK: Project development, manuscript writing.

Corresponding author

Correspondence to Giuseppe Rosiello.

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Rosiello, G., Palumbo, C., Knipper, S. et al. Comparison of survival outcomes in patients with metastatic papillary vs. clear-cell renal cell carcinoma: a propensity-score analysis. World J Urol 39, 461–472 (2021). https://doi.org/10.1007/s00345-020-03187-y

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  • DOI: https://doi.org/10.1007/s00345-020-03187-y

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