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Does chromophobe renal cell carcinoma have better survival than clear cell renal cell carcinoma? A clinical-based cohort study and meta-analysis

  • Urology - Original Paper
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Abstract

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.

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References

  1. Storkel S, Eble JN, Adlakha K, Amin M, Blute ML, Bostwick DG et al (1997) Classification of renal cell carcinoma: Workgroup No. 1. Union Internationale Contre le Cancer (UICC) and the American Joint Committee on Cancer (AJCC). Cancer 80(5):987–989

    Article  PubMed  CAS  Google Scholar 

  2. Lam JS, Leppert JT, Figlin RA, Belldegrun AS (2005) Surveillance following radical or partial nephrectomy for renal cell carcinoma. Curr Urol Rep 6(1):7–18

    Article  PubMed  Google Scholar 

  3. Capitanio U, Cloutier V, Zini L, Isbarn H, Jeldres C, Shariat SF et al (2009) A critical assessment of the prognostic value of clear cell, papillary and chromophobe histological subtypes in renal cell carcinoma: a population-based study. BJU Int 103(11):1496–1500

    Article  PubMed  Google Scholar 

  4. Klatte T, Han KR, Said JW, Bohm M, Allhoff EP, Kabbinavar FF et al (2008) Pathobiology and prognosis of chromophobe renal cell carcinoma. Urol Oncol 26(6):604–609

    Article  PubMed  Google Scholar 

  5. Lee WK, Byun SS, Kim HH, Rha KH, Hwang TK, Sung GT et al (2010) Characteristics and prognosis of chromophobe non-metastatic renal cell carcinoma: a multicenter study. Int J Urol 17(11):898–904

    Article  PubMed  Google Scholar 

  6. Teloken PE, Thompson RH, Tickoo SK, Cronin A, Savage C, Reuter VE et al (2009) Prognostic impact of histological subtype on surgically treated localized renal cell carcinoma. J Urol 182(5):2132–2136

    Article  PubMed  PubMed Central  Google Scholar 

  7. Katz MD, Serrano MF, Humphrey PA, Grubb RL 3rd, Skolarus TA, Gao F et al (2011) The role of lymphovascular space invasion in renal cell carcinoma as a prognostic marker of survival after curative resection. Urol Oncol 29(6):738–744

    Article  PubMed  Google Scholar 

  8. Keegan KA, Schupp CW, Chamie K, Hellenthal NJ, Evans CP, Koppie TM (2012) Histopathology of surgically treated renal cell carcinoma: survival differences by subtype and stage. J Urol 188(2):391–397

    Article  PubMed  PubMed Central  Google Scholar 

  9. Lam JS, Klatte T, Patard JJ, Goel RH, Guille F, Lobel B et al (2007) Prognostic relevance of tumour size in T3a renal cell carcinoma: a multicentre experience. Eur Urol 52(1):155–162

    Article  PubMed  Google Scholar 

  10. Leibovich BC, Lohse CM, Crispen PL, Boorjian SA, Thompson RH, Blute ML et al (2010) Histological subtype is an independent predictor of outcome for patients with renal cell carcinoma. J Urol 183(4):1309–1315

    Article  PubMed  Google Scholar 

  11. Ljungberg B, Alamdari FI, Stenling R, Roos G (1999) Prognostic significance of the Heidelberg classification of renal cell carcinoma. Eur Urol 36(6):565–569

    Article  PubMed  CAS  Google Scholar 

  12. Moch H, Gasser T, Amin MB, Torhorst J, Sauter G, Mihatsch MJ (2000) Prognostic utility of the recently recommended histologic classification and revised TNM staging system of renal cell carcinoma: a Swiss experience with 588 tumors. Cancer 89(3):604–614

    Article  PubMed  CAS  Google Scholar 

  13. Patard JJ, Leray E, Rioux-Leclercq N, Cindolo L, Ficarra V, Zisman A et al (2005) Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol 23(12):2763–2771

    Article  PubMed  Google Scholar 

  14. Ficarra V, Martignoni G, Galfano A, Novara G, Gobbo S, Brunelli M et al (2006) Prognostic role of the histologic subtypes of renal cell carcinoma after slide revision. Eur Urol 50(4):786–793; discussion 93-4

  15. Gudbjartsson T, Hardarson S, Petursdottir V, Thoroddsen A, Magnusson J, Einarsson GV (2005) Histological subtyping and nuclear grading of renal cell carcinoma and their implications for survival: a retrospective nation-wide study of 629 patients. Eur Urol 48(4):593–600

    Article  PubMed  Google Scholar 

  16. Stang A (2010) Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25(9):603–605

    Article  PubMed  Google Scholar 

  17. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188

    Article  PubMed  CAS  Google Scholar 

  18. Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. Br Med J 327(7414):557–560

    Article  Google Scholar 

  19. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  20. Zubac DP, Bostad L, Gestblom C, Kihl B, Seidal T, Wentzel-Larsen T et al (2007) Renal cell carcinoma: a clinicopathological follow-up study after radical nephrectomy. Scand J Urol Nephrol 41(3):191–197

    Article  PubMed  Google Scholar 

  21. Dall’Oglio MF, Arap MA, Antunes AA, Cury J, Leite KR, Srougi M (2007) Impact of clinicopathological parameters in patients treated for renal cell carcinoma. J Urol 177(5):1687–1691

    Article  PubMed  Google Scholar 

  22. Minervini A, Serni S, Tuccio A, Siena G, Vittori G, Masieri L et al (2012) Simple enucleation versus radical nephrectomy in the treatment of pT1a and pT1b renal cell carcinoma. Ann Surg Oncol 19(2):694–700

    Article  PubMed  Google Scholar 

  23. Schuetz AN, Yin-Goen Q, Amin MB, Moreno CS, Cohen C, Hornsby CD et al (2005) Molecular classification of renal tumors by gene expression profiling. J Mol Diagn 7(2):206–218

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  24. Steffens S, Roos FC, Janssen M, Becker F, Steinestel J, Abbas M et al (2014) Clinical behavior of chromophobe renal cell carcinoma is less aggressive than that of clear cell renal cell carcinoma, independent of Fuhrman grade or tumor size. Virchows Arch 465(4):439–444

    Article  PubMed  CAS  Google Scholar 

  25. Crepel M, Isbarn H, Capitanio U, Liberman D, Jeldres C, Sun M et al (2009) Does histologic subtype affect oncologic outcomes after nephron-sparing surgery? Urology 74(4):842–845

    Article  PubMed  Google Scholar 

  26. Stec R, Grala B, Maczewski M, Bodnar L, Szczylik C (2009) Chromophobe renal cell cancer—review of the literature and potential methods of treating metastatic disease. J Exp Clin Cancer Res 28:134

    Article  PubMed  PubMed Central  Google Scholar 

  27. Thoenes W, Storkel S, Rumpelt HJ, Moll R, Baum HP, Werner S (1988) Chromophobe cell renal carcinoma and its variants—a report on 32 cases. J Pathol 155(4):277–287

    Article  PubMed  CAS  Google Scholar 

  28. Waldert M, Klatte T, Haitel A, Ozsoy M, Schmidbauer J, Marberger M et al (2010) Hybrid renal cell carcinomas containing histopathologic features of chromophobe renal cell carcinomas and oncocytomas have excellent oncologic outcomes. Eur Urol 57(4):661–665

    Article  PubMed  Google Scholar 

  29. Ornellas AA, Andrade DM, Ornellas P, Wisnescky A, Schwindt AB (2012) Prognostic factors in renal cell carcinoma: analysis of 227 patients treated at the Brazilian National Cancer Institute. Int Braz J Urol 38(2):185–194

    Article  PubMed  Google Scholar 

  30. Tickoo SK, Gopalan A (2008) Pathologic features of renal cortical tumors. Urol Clin N Am 35(4):551–561

    Article  Google Scholar 

  31. Cohen HT, McGovern FJ (2005) Renal-cell carcinoma. N Engl J Med 353(23):2477–2490

    Article  PubMed  CAS  Google Scholar 

  32. Furge KA, Lucas KA, Takahashi M, Sugimura J, Kort EJ, Kanayama HO et al (2004) Robust classification of renal cell carcinoma based on gene expression data and predicted cytogenetic profiles. Cancer Res 64(12):4117–4121

    Article  PubMed  CAS  Google Scholar 

  33. Coppin C, Kollmannsberger C, Le L, Porzsolt F, Wilt TJ (2011) Targeted therapy for advanced renal cell cancer (RCC): a cochrane systematic review of published randomised trials. BJU Int 108(10):1556–1563

    Article  PubMed  CAS  Google Scholar 

  34. Stewart GD, O’Mahony FC, Powles T, Riddick AC, Harrison DJ, Faratian D (2011) What can molecular pathology contribute to the management of renal cell carcinoma? Nat Rev Urol 8(5):255–265

    Article  PubMed  CAS  Google Scholar 

  35. Yusenko MV (2010) Molecular pathology of chromophobe renal cell carcinoma: a review. Int J Urol 17(7):592–600

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by National Natural Science Foundation of China (Nos. 81172429, 81372357, U1301221, 81372730, and 81225018) and the Guangdong Provincial Science and Technology Foundation (No. 2013B021800133).

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    Authors and Affiliations

    1. Department of Urology, First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, People’s Republic of China

      Hui-Ming Jiang, Jin-Huan Wei, Yong Fang, Bang-Fen Zhou, Zhen-Hua Chen, Jun Lu, Bing Liao, Jun-Hang Luo & Wei Chen

    2. Department of Urology, Meizhou People’s Hospital, No. 63, Huang Tang Road, Meizhou, 514031, Guangdong, People’s Republic of China

      Hui-Ming Jiang

    3. Department of Urology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People’s Republic of China

      Zhi-Ling Zhang & Fang-Jian Zhou

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    Hui-Ming Jiang and Jin-Huan Wei have contributed equally to this work.

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    Jiang, HM., Wei, JH., Zhang, ZL. et al. Does chromophobe renal cell carcinoma have better survival than clear cell renal cell carcinoma? A clinical-based cohort study and meta-analysis. Int Urol Nephrol 48, 191–199 (2016). https://doi.org/10.1007/s11255-015-1161-3

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