Cytoplasmic expression of B7-H3 and membranous EpCAM expression are associated with higher grade and survival outcomes in patients with clear cell renal cell carcinoma

e16068 Background: Use of TKIs is standard of care for metastatic ccRCC and cytoreductive nephrectomy has improved survival even in metastatic ccRCC. The use of cytoreductive nephrectomy in the TKI era post-2005 for nccRCC histologies is unknown. We sought to determine trends and explore differences in characteristics of ccRCC and nccRCC, use of cytoreductive nephrectomy and survival outcomes for varying stages. Methods: Using a de-identified dataset acquired from the NCDB from 2004 to 2014, extraction of demographic information on patients divided into ccRCC versus nccRCC. Descriptive statistics was used for summarizing patients’ characteristics. Chi-Square test was used for comparing categorical variables. Two-sample t-test was used for comparing continuous variables. Kaplan-Meier method was used to analyze patients’ survival data. Results: 302,339 (82%) ccRCC and 66,530 (18%) nccRCC patients were identified. nccRCC included papillary (n = 42,251), sarcomatoid (n = 5769), chromophobe (n = 17,671) and collecting duct (n = 839). The median age for both groups was 63 years, more common in males (ccRCC = 61%; nccRCC = 69%), and mostly Caucasians (ccRCC = 86%; nccRCC = 75%). Most patients were treated in comprehensive community and academic research programs (ccRCC = 81%; nccRCC = 83%). Majority of patients were diagnosed with AJCC Stage I (ccRCC = 57%, nccRCC = 62%). Stage IV was diagnosed in 14% of ccRCC and 9% of nccRCC. The utilization of nephrectomy declined for ccRCC at 36% in the year 2014 compared to 44% in 2005, whereas it declined more for nccRCC with 47% in 2014 compared to 70% in 2005. The median survival time for Stage I was comparable in both groups (ccRCC = 140 mos, 95% CI 138.8 – 142.16; nccRCC = 140 mos, 95% CI 138 – unestimable). However, median survival was worse for stage IV in nccRCC (ccRCC = 9 mos; 95% CI 8.8 – 9.17; nccRCC = 7.43 mos; 95% CI 7.16 – 7.79). Conclusions: In stage IV patients with nccRCC, cytoreductive nephrectomy is used less often and overall survival appears inferior compared to ccRCC.

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818 Comparative effectiveness of adrenal sparing radical nephrectomy and non-adrenal sparing radical nephrectomy in clear cell renal cell carcinoma: Observational study of survival outcomes

European Urology Supplements ◽

10.1016/s1569-9056(15)60807-7 ◽

2015 ◽

Vol 14 (2) ◽

pp. e818

Author(s):

G. Nason ◽

L. Walsh ◽

C. Redmond ◽

N. Kelly ◽

B. McGuire ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Observational Study ◽

Cell Carcinoma ◽

Renal Cell ◽

Comparative Effectiveness ◽

Radical Nephrectomy ◽

Clear Cell ◽

Survival Outcomes ◽

Cell Renal Cell Carcinoma

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Surgery and survival outcomes of 30 patients with neurological deficit due to clear cell renal cell carcinoma spinal metastases

European Spine Journal ◽

10.1007/s00586-015-3912-3 ◽

2015 ◽

Vol 24 (8) ◽

pp. 1786-1791 ◽

Cited By ~ 11

Author(s):

Shuai Han ◽

Ting Wang ◽

Dongjie Jiang ◽

Yang Yu ◽

Yu Wang ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Neurological Deficit ◽

Renal Cell ◽

Clear Cell ◽

Spinal Metastases ◽

Survival Outcomes ◽

Cell Renal Cell Carcinoma

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Papillary type 2 versus clear cell renal cell carcinoma: Survival outcomes

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2016.08.003 ◽

2016 ◽

Vol 42 (11) ◽

pp. 1744-1750 ◽

Cited By ~ 8

Author(s):

G. Simone ◽

G. Tuderti ◽

M. Ferriero ◽

R. Papalia ◽

L. Misuraca ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Survival Outcomes ◽

Cell Renal Cell Carcinoma ◽

Papillary Type

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Comparative effectiveness of adrenal sparing radical nephrectomy and non-adrenal sparing radical nephrectomy in clear cell renal cell carcinoma: Observational study of survival outcomes

Canadian Urological Association Journal ◽

10.5489/cuaj.2842 ◽

2015 ◽

Vol 9 (9-10) ◽

pp. 583 ◽

Cited By ~ 1

Author(s):

Gregory J. Nason ◽

Leon G. Walsh ◽

Ciaran E. Redmond ◽

Niall P. Kelly ◽

Barry B. McGuire ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Observational Study ◽

Cell Carcinoma ◽

Renal Cell ◽

Radical Nephrectomy ◽

Clear Cell ◽

Risk Groups ◽

Survival Outcomes ◽

Cell Renal Cell Carcinoma

Introduction: We compare the survival outcomes of patients with clear cell renal cell carcinoma (RCC) treated with adrenal sparing radical nephrectomy (ASRN) and non-adrenal sparing radical nephrectomy (NASRN).Methods: We conducted an observational study based on a composite patient population from two university teaching hospitals who underwent RN for RCC between January 2000 and December 2012. Only patients with pathologically confirmed RCC were included. We excluded patients undergoing cytoreductive nephrectomy, with loco-regional lymph node involvement. In total, 579 patients (ASRN = 380 and NASRN = 199) met our study criteria. Patients were categorized by risk groups (all stage, early stage and locally advanced RCC). Overall survival (OS) and cancer-specific survival (CSS) were analyzed for risk groups. Survival analysis was performed using Kaplan-Meier curves and Cox proportional hazards regression.Results: The median follow-up was 41 months (range: 12–157). There were significant benefits in OS (ASRN 79.5% vs. NASRN 63.3%; p = 0.001) and CSS (84.3% vs.74.9%; p = 0.001), with any differences favouring ASRN in all stage. On multivariate analysis, there was a trend towards worse OS (hazard ratio [HR] 1.759, 95% confidence interval [CI] 0.943–2.309, p = 0.089) and CSS (HR 1.797, 95% CI 0.967–3.337, p = 0.064) in patients with NASRN (although not statistically significant). Of these patients, only 11 (1.9%) had adrenal involvement.Conclusions: The inherent limitations in our study include the impracticality of conducting a prospective randomized trial in this scenario. Our observational study with a 13-year follow-up suggests ASRN leads to better survival than NASRN. ASRN should be considered the gold standard in treating patients with RCC, unless it is contraindicated.

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Association of Tumor Size with Risk of Lymph Node Metastasis in Clear Cell Renal Cell Carcinoma: A Population-Based Study

Journal of Oncology ◽

10.1155/2020/8887782 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Yunlai Zhi ◽

Xiao Li ◽

Feng Qi ◽

Xin Hu ◽

Wenbo Xu

Keyword(s):

Renal Cell Carcinoma ◽

Lymph Node ◽

Cell Carcinoma ◽

Tumor Size ◽

Renal Cell ◽

Clear Cell ◽

Personal Characteristics ◽

Survival Outcomes ◽

Cell Renal Cell Carcinoma ◽

Increased Risk

The purpose of this article was to explore the association of tumor size with lymph node metastases (LNM) risk in patients with clear cell renal cell carcinoma (ccRCC). Based on the Surveillance, Epidemiology, and End Result (SEER) database, patients diagnosed with ccRCC from 1988 to 2015 were included in this study. For each patient, personal characteristics, clinicopathological data, and survival outcomes were, respectively, collected. Subsequently, the odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to investigate the potential risk factors for LNM in ccRCC. Finally, Kaplan-Meier (KM) survival plots of overall survival (OS) and ccRCC-specific survival (CSS) were evaluated on the basis of different tumor sizes. A total of 8,292 patients were finally enrolled in the study, 1,170 of whom (14.11%) had LNM. According to the heatmap, we could intuitively interpret that larger tumor size was related to an increased risk of LNM obviously. The risk of LNM was evidently greater for larger tumor size (4-7 cm: OR = 2.415, 95% CI = 1.708–3.415; 7–10 cm: OR = 3.746, 95% CI = 2.677–5.242; and >10 cm: OR = 4.617, 95% CI = 3.302–6.457) compared with smaller tumor size (≤4 cm). According to the KM survival plots of OS and CSS, we observed a gradual decline in survival with increasing tumor size, while the smallest tumor size had the best survival outcomes. These results indicated the positive relationship of tumor size with risk of LNM in ccRCC. And we also noticed continual decrease survival rates of OS and CSS with increasing tumor size.

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