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Comparison of oncologic outcomes between sarcomatoid and clear cell renal cell carcinoma

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Abstract

Background

Sarcomatoid renal cell carcinoma (sRCC) is a rare histological subtype that is associated with unfavorable prognosis. We sought to examine the effect of sRCC on cancer-specific mortality (CSM) relative to clear cell renal cell carcinoma (ccRCC), after adjusting for other variables, as well as other-cause mortality (OCM).

Methods

We relied on the Surveillance, Epidemiology, and End Results–Medicare database from 2000 to 2009 to identify a cohort of 7916 patients with either sRCC (n = 234) or ccRCC (n = 7682) who received surgery as primary treatment. Patient, tumor, and treatment characteristics were evaluated. Then, 5-year smoothed Poisson regression CSM and OCM estimates were generated for stage-by-stage comparisons between sRCC and ccRCC. A multivariable competing-risks regression model predicting CSM and adjusting for several patient and tumor characteristics, as well as OCM, was finally fitted.

Results

Compared to ccRCC patients, sRCC patients had more advanced and more aggressive disease at diagnosis. Specifically, 48 and 7 % of sRCC and ccRCC patients presented with stage IV disease, respectively (p < 0.001). Overall, 5-year CSM and OCM estimates were 67 and 17 % for sRCC patients and 14 and 19 % for ccRCC patients. In stage-by-stage analyses, sRCC was invariably associated with worse CSM. After adjusting for several characteristics as well as OCM, sRCC was associated with a 3.2 higher risk of CSM compared with ccRCC.

Conclusions

Patients with sRCC are present with more advanced disease. Moreover, sRCC is associated with a higher rate of CSM, even after adjusting for several characteristics and OCM.

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Authors’ contribution

Trudeau, Larcher, Karakiewicz contributed to protocol/project development. Trudeau, Larcher, Tian, Sun, Karakiewicz were involved in data collection or management. Trudeau, Larcher, Tian, Karakiewicz analyzed the data. Trudeau, Larcher, Karakiewicz contributed to manuscript writing/editing. Boehm, Fossati, Dell’Oglio, Briganti, Shariat, Sosa, Karakiewicz critically revised the manuscript for important intellectual content. Sun and Karakiewicz are acknowledged for supervision.

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Authors and Affiliations

  1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, 264 Blvd. Rene-Levesque E. Room 228, Montreal, QC, H2X 1P1, Canada

    Vincent Trudeau, Alessandro Larcher, Maxine Sun, Katharina Boehm, Paolo Dell’Oglio, José Sosa, Zhe Tian & Pierre I. Karakiewicz

  2. Department of Urology, University of Montreal Health Center, Montreal, Canada

    Vincent Trudeau & Pierre I. Karakiewicz

  3. Division of Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

    Alessandro Larcher, Paolo Dell’Oglio, Nicola Fossati & Alberto Briganti

  4. Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany

    Katharina Boehm

  5. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada

    Zhe Tian

  6. Department of Urology, Medical University of Vienna, Vienna, Austria

    Shahrokh F. Shariat

Authors
  1. Vincent Trudeau
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  2. Alessandro Larcher
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  3. Maxine Sun
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  4. Katharina Boehm
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  5. Paolo Dell’Oglio
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  6. José Sosa
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  7. Zhe Tian
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  8. Nicola Fossati
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  9. Alberto Briganti
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  10. Shahrokh F. Shariat
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  11. Pierre I. Karakiewicz
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Corresponding author

Correspondence to Vincent Trudeau.

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Conflict of interest

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors declare no conflicts of interest in preparing this article.

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Trudeau, V., Larcher, A., Sun, M. et al. Comparison of oncologic outcomes between sarcomatoid and clear cell renal cell carcinoma. World J Urol 34, 1429–1436 (2016). https://doi.org/10.1007/s00345-016-1780-z

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  • DOI: https://doi.org/10.1007/s00345-016-1780-z

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