Survival outcomes in metastatic renal carcinoma based on histological subtypes: SEER database analysis.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 381-381 ◽  
Author(s):  
N. Didwaniya ◽  
R. J. Edmonds ◽  
X. Fang ◽  
P. T. Silberstein ◽  
S. Subbiah
Keyword(s):  
Renal Carcinoma ◽  
Clear Cell ◽  
Collecting Duct ◽  
Cell Cancer ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Papillary Collecting Duct ◽  
Clear Cell Rccs ◽  
Clear Cell Rcc ◽  
Metastatic Rcc

381 Background: Renal cell cancer (RCC) represents a heterogeneous group of tumors with distinct histopathologic, genetic, and clinical features. This study was conducted to evaluate the prognostic value of histology in RCCs. Methods: 3,062 patients with metastatic RCC from year 1998-2007 were identified from Surveillance Epidemiology and End Results (SEER) database. Data regarding their age, sex, race, treatment modality utilized and cancer specific survival was extracted and analyzed. Results: Clear cell, sarcomatoid, adenocarcinoma NOS, papillary, collecting duct, chromophobe and cyst associated renal carcinoma accounted for 2,166 (70%), 433 (14%), 216 (7%), 160 (52%), 47 (1.5%), 35 (1.14%), and 5 (0.01%) respectively. The mean age of presentation was 63.5 in clear cell RCC and 62.7 years in non-clear cell RCC. Surgery was performed in 57.23% of all clear cell cancers and 50.84% in non-clear cell-RCC group. 27.34% of all clear cell cancer patients received radiation in contrast to 34.53% in the other group. Both clear cell RCC (64.54%) and non-clear cell RCC (69.52%) occurred commonly in males. Incidence of clear cell RCC was 4.67% in Asians, 7.01% in Blacks, 88.32% in Whites. The incidence of non-clear cell RCC was 3.81% in Asians, 14.78% in Blacks, and 81.41% in Whites. Cancer-specific survival was calculated in all histologic subtypes. Median survival for clear cell RCC was 8 months, 3 months for adenocarcinoma NOS, 7 months for cyst associated renal carcinoma, 8 months for papillary carcinoma, 7 months for chromophobe type, 4 months for sarcomatoid and 4 months for collecting duct RCC. Median overall survival was significantly better for clear cell cancer as compared to non-clear cell RCCs (8 months vs. 4 months; p< 0.0001). Conclusions: Non-clear histology RCCs represent 30% of metastatic RCC and are associated with poor prognosis when compared to clear cell RCC.While development of novel targeted therapies has improved survival in clear cell RCC, it has not made a impact in survival of non-clear RCCs. An indepth understanding of the genetic and molecular changes associated with non-clear cell RCCs is important to improve their prognosis. No significant financial relationships to disclose.

scholarly journals Distinct Effect of Body Mass Index by Sex as a Prognostic Factor in Localized Renal Cell Carcinoma Treated with Nephrectomy ~ Data from a Multi-Institutional Study in Japan ~

2020 ◽  
Author(s):  
Takeshi Tsutsumi ◽  
Kazumasa Komura ◽  
Takeshi Hashimoto ◽  
Ryu Muraoka ◽  
Naoya Satake ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Clear Cell ◽  
Independent Predictor ◽  
Cox Model ◽  
Cancer Specific Survival ◽  
Asian Patients ◽  
Localized Renal Cell Carcinoma ◽  
Patient Subgroups ◽  
Metastatic Rcc

Abstract Background: We assessed the prognostic value of body mass index (BMI) in Asian patients with localized RCC who underwent nephrectomy.Methods: A total of 665 patients who underwent nephrectomy for localized RCC were enrolled in the present study and divided into the two BMI groups: i.e., BMI <25 in 463 (69.6%) and BMI >25 in 202 (30.4%) patients.Results: In total, there were 482 (72.5%) males and 183 (27.5%) females. Five-year cancer-specific survival (CSS) rates were significantly higher in increased BMI compared to lower BMI group (97.1 and 92.5%: P = 0.007). When stratified by sex, significantly longer CSS in higher BMI was confirmed in male (5-year CSS of 92.7% in BMI <25 and 98.1% in BMI >25, p=0.005), while there was no difference in CSS between BMI groups for female patients. Multivariate analysis exhibited that higher BMI was an independent predictor for favorable CSS in male (cox model: p=0.041, Fine & Gray regression model: p=0.014), but not in the female. Subgroup analysis for CSS revealed that favorable CSS with higher BMI was observed in patient subgroups of age <65 (p=0.019), clear cell histology (p=0.018), and tumor size >4cm, p=0.020) as well as male (p=0.020).Conclusion: Our findings collected from the multi-institutional Japanese dataset demonstrated the longer survival in patients with higher BMI than lower BMI for non-metastatic RCC treated with nephrectomy. Intriguingly, this finding was restricted to males, but not to females.

Histopathology in surgically treated renal cell carcinoma: Is there a survival difference when stratified by stage?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5089-5089
Author(s):  
K. A. Keegan ◽  
N. J. Hellenthal ◽  
K. Chamie ◽  
T. M. Koppie
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Collecting Duct ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Cancer Specific Survival ◽  
Stage Disease ◽  
The Impact

5089 Background: The impact of renal cell carcinoma histopathology (RCC) on survival has been conflicting and limited to retrospective institutional studies. Therefore, we sought to determine the role of RCC histopathology on stage-specific survival rates in a population-based cohort. Methods: We utilized the National Cancer Institute's Surveillance, Epidemiology, and End Results database and identified 21,258 patients who underwent partial or radical nephrectomy for RCC between 1996 and 2004. Patients were stratified based on histopathologic diagnosis (clear cell, papillary, chromophobe, sarcomatoid, and collecting duct) and pathologic stage. We performed Cox-proportional hazard modeling and Kaplan-Meier survival analyses to determine overall- and cancer-specific survival. Results: Using univariate analysis, histopathology significantly impacted overall- and cancer-specific survival (p< 0.001). Specifically, patients with papillary and chromophobe variants had lower stage disease at the time of surgery and had improved survival compared to clear cell subtypes, (HR: 0.50; 95% CI, 0.42–0.60 and HR: 0.31; 95% CI, 0.22–0.44, respectively). When controlled for stage, improved outcomes for chromophobe and papillary histologies persisted, although it did not achieve statistical significance at all stages. On the other hand, patients with sarcomatoid disease were more likely to present with high stage disease and invariably had worse survival compared to clear cell carcinoma (HR: 8.74; 95%, CI 7.70–9.91). When controlled for stage, this difference achieved statistical significance across all stages (p< 0.001). Conclusions: Histopathologic subtype in patients with RCC does predict overall- and cancer-specific survival. Patients with sarcomatoid RCC, even those presenting with low-stage disease, have poor survival. These findings may give further value to recent data suggesting the increased utility of percutaneous renal biopsy and its potential impact on management. [Table: see text] No significant financial relationships to disclose.

Evolving trends in non-clear cell renal cell cancer (RCC) epidemiology: A large registry analysis of 4,483 patients.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 374-374
Author(s):  
Ashok P. Pai ◽  
Monica Brown ◽  
Chong-xian Pan ◽  
Primo Lara
Keyword(s):  
Cancer Registry ◽  
Clear Cell ◽  
Collecting Duct ◽  
Univariate Analysis ◽  
Cell Cancer ◽  
Emerging Trends ◽  
Hazard Ratios ◽  
California Cancer Registry ◽  
Registry Analysis ◽  
Histologic Subtypes

374 Background: Non-clear cell (ncc) RCC is uncommon but includes a heterogeneous group of histologic subtypes such as papillary, chromophobe (Chr), medullary (Med), and collecting duct (CD) cancers. We used a large cancer registry to define nccRCC clinical features and outcomes, identify prognostic variables, and to generate hypotheses for further study. Methods: Invasive RCC tumors in the California Cancer Registry from 1998–2009 among adults > 18 years of age (n=38,251) were analyzed. Baseline clinical and tumor variables were collected. Primary outcome measures were 3-year cause-specific (CSS) and overall survival (OS). Uni- and multivariate survival analysis were used to identify predictors of CSS and OS. Results: Of 38,251 RCC cases, 19,149 (50%) were of clear cell type; 14,619 (38.2%) were “unclassified”. Thus, 4,483 (11.7%) nccRCC cases were identified and included in this analysis. Of these, 3304 (73.7%) were diagnosed in 2004–09, suggesting a shift to more precise coding of histologic subtypes starting in the early 2000s. Histology distribution (n, %): papillary − 2,863 (63.9%); Chr − 1,507 (33.6%); and other including Med and CD − 113 (2.5%). Variables associated with significantly better OS and CSS (univariate analysis) were Chr histology, female sex, and higher socioeconomic status (SES). Significantly worse OS and CSS were seen in Med+CD, age > 65 yrs, no nephrectomy (Nx), and higher stage. Non-hispanic blacks had significantly worse OS and CSS, while the “targeted therapy era” (2004–2009) was associated with better OS. Multivariate analysis showed the following to be independently associated with outcomes (all p <0.001; Hazard Ratios [HR] shown for CSS and OS): Chr histology (0.48, 0.56), Med+CD histology (2.99, 2.42), no Nx (2.84, 3.18), regional stage (5.84, 1.98), distant stage (25.7, 7.67); and non-hispanic blacks (1.5,2 p=0.006; 1.25, p=0.03). Age > 65 yrs (HR 1.78, p<0.001) and high SES (HR 0.88, p=0.001) were associated with OS but not CSS. Conclusions: This is among the largest registry analyses of nccRCC ever performed, showing emerging trends in this uncommon RCC subset. Clinical variables associated with CSS and OS were identified that can inform the design of future clinical trials in nccRCC.

Clinical prognostic factors associated with outcome in patients with metastatic clear-cell renal cell cancer treated with everolimus.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 443-443
Author(s):  
Robert J. Amato ◽  
Amber Flaherty ◽  
Somyata Saxena ◽  
Mika Stepankiw
Keyword(s):  
Prognostic Factors ◽  
Renal Cell Cancer ◽  
Renal Cell ◽  
Clear Cell ◽  
Left Kidney ◽  
Cell Cancer ◽  
Progression Free Survival ◽  
Factors Associated ◽  
Kidney Involvement ◽  
Clear Cell Rcc

443 Background: Everolimus, an oral mammalian target of rapamycin (mTOR) inhibitor, has demonstrated efficacy affects tumor growth by blocking growth factor stimulation, arresting cell cycle progression, and inhibiting angiogenesis. mTOR inhibitors and agents with primarily antiangiogenic activity have been shown to have efficacy in renal cell cancer (RCC). This study expanded the original everolimus study of 41 patients with metastatic clear cell renal cell cancer to 66 patients to examine outcome and clinical prognostic factors associated with outcome Methods: Patients had confirmed predominantly clear cell RCC. Everolimus was given at a dose of 10 mg daily orally without interruption (28-day cycle), with dose modifications for toxicity (graded according to National Cancer Institute Common Toxicity Criteria, version 3.0). Patients were evaluated every 2 cycles (8 weeks) using Response Evaluation Criteria in Solid Tumors (RECIST). Results: Of 66 evaluable and treated patients, 73% were male, and 45% were >60. Forty-five percent had right kidney involvement, 49% left kidney involvement, and 6% had dual kidney involvement. Eighty-six percent had prior systemic therapy, and 76% of patients had at least two metastatic sites including lung (72%), liver (26%), bone (48%), lymph nodes (50%), adrenal (21%), and other (39%). Twenty-four (36%) of patients had a progression-free survival (PFS) of ≥12 months, and 40 patients (61%) had an overall survival (OS) ≥12 months. Factors most likely to have an influence on OS benefit was high LDH, alkaline phosphatase, and calcium; low hemoglobin; and prior treatment with tyrokinase inhibitors. Conclusions: Everolimus was found to have clinical benefit in patients with clear cell RCC. Clinical prognostic factors may help determine patients most likely to receive benefit from everolimus. Information regarding curves and correlation between prognostic factors and OS and PFS will be presented.

Comparision of histologic distribution of RCC in young and older patients: Results from the SEER database.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 419-419 ◽  
Author(s):  
Michael R. Daugherty ◽  
Stephen Blakely ◽  
Oleg Shapiro ◽  
Gennady Bratslavsky
Keyword(s):  
Renal Cell ◽  
Clear Cell ◽  
Collecting Duct ◽  
Cell Cancer ◽  
Age Groups ◽  
Genetic Mutations ◽  
Chi Square ◽  
Younger Patients ◽  
The Difference ◽  
Chi Square Analysis

419 Background: Renal cell cancer (RCC) incidence is relatively low in younger patients, encompassing 3-5% of all RCC tumors. These tumors tend to be due to hereditary syndromes and genetic mutations that predispose to cancer development. Patients with hereditary renal cancer (HRC) are at a higher risk of multiple tumors and bilateral disease. We hypothesize that there is a difference in histologic distribution in the younger patients and that the younger distribution contains more aggressive histologic subtypes. Methods: SEER 18-registries database was queried for all patients ≥20 years old that were surgically treated for renal cell carcinoma between the years 2001 and 2008. Patients with unknown race, grade, stage, or histology were excluded from the study. Histologies selected were clear cell, papillary, chromophobe, sarcomatoid, and collecting duct. Three cohorts were created with the ages 20-44, 45-64, and ≥65 year olds that contained 3,926, 19,661, and 16,323 patients respectively. Chi-square analysis was used to compare the histologic distributions between the cohorts. Results: There was no difference in the incidence of clear cell RCC between the three cohorts (p = 0.63). The histology distribution was not different in the 45-64 year olds compared to those ≥65 (p = 0.47). The non-clear cell histologies were different between the 3 age groups (p < 0.001). There were a larger percentage of patients in the younger patients that had chromophobe tumors compared to all non-clear cell histologies (p< 0.001). Conclusions: The difference in the non-clear cell histologic distribution between the groups is most likely due to genetic mutations predisposing these patients to chromophobe RCC. There has been limited data on HRCs, due in large part to its low incidence. Although the HRCs are known to have a most common histology, it is likely that this information is incomplete, as younger patients have undiagnosed genetic mutations that led to development of chromophobe tumors. [Table: see text]

scholarly journals Decreased Expression of Inhibitor of Caspase-Activated DNase (ICAD) in Renal Cell Carcinoma – Tissue Microarray of Human Samples

2016 ◽  
Vol 3 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Retnagowri Rajandram ◽  
Azad H. A. Razack ◽  
Keng Lim Ng ◽  
Glenda C Gobe
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Tissue Microarray ◽  
Renal Cell ◽  
Clear Cell ◽  
Normal Kidney ◽  
Down Regulation ◽  
Caspase Activated Dnase ◽  
Clear Cell Rcc ◽  
Metastatic Rcc

Although primary localised tumours of renal cell carcinoma (RCC) can be treated relatively successfully with surgery, metastatic RCC has poor prognosis because of late diagnosis and resistance to therapies. In the present study, we were interested in profiling the protein expression of “inhibitor of caspase-activated DNase” (ICAD), an apoptosis inhibitor, in kidney cancer and its paired normal kidney. Immunohistochemistry with automated batch staining and morphometry using digital pathology were used to compare ICAD in 121 RCC specimens with their paired normal kidney tissue. Tissue microarray of formalin-fixed, paraffin-embedded archival tissue was used. Intensity and localisation of ICAD were compared between normal and cancer samples, and against grading within the cancers. The results demonstrated that, in this cohort, ICAD was highly expressed in the proximal tubular epithelium of normal kidney, and significantly decreased in clear cell RCC tissue (p < 0.05) as well as other subtypes of RCC (p < 0.01) compared with normal kidney. There was a tendency towards nuclear localisation of ICAD in clear cell RCC, but not in other subtypes of RCC. No significant association was found between ICAD intensity and grade of RCC. In summary, down-regulation of ICAD occurs in RCC. ICAD normally inhibits DNA fragmentation and apoptosis; thus, its down-regulation was unexpected in a cancer known for its resistance to apoptosis. However, these RCC samples were from primary, not metastatic, RCC sites, and down-regulated ICAD may be part of a progressive pathway that promotes RCC metastasis.

scholarly journals Renal Cell Carcinoma in the Era of Precision Medicine: From Molecular Pathology to Tissue-Based Biomarkers

2018 ◽  
Vol 36 (36) ◽  
pp. 3553-3559 ◽  
Author(s):  
Sabina Signoretti ◽  
Abdallah Flaifel ◽  
Ying-Bei Chen ◽  
Victor E. Reuter
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Checkpoint Inhibitors ◽  
Predictive Biomarkers ◽  
Molecular Features ◽  
Pathologic Features ◽  
Clear Cell Rcc ◽  
Metastatic Rcc

Renal cell carcinoma (RCC) is not a single entity but includes various tumor subtypes that have been identified on the basis of either characteristic pathologic features or distinctive molecular changes. Clear cell RCC is the most common type of RCC and is characterized by dysregulation of the von Hippel Lindau/hypoxia-inducible factor pathway. Non–clear cell RCC represents a more heterogeneous group of tumors with diverse histopathologic and molecular features. In the past two decades, the improved understanding of the molecular landscape of RCC has led to the development of more effective therapies for metastatic RCC, which include both targeted agents and immune checkpoint inhibitors. Because only subsets of patients with metastatic RCC respond to a given treatment, predictive biomarkers are needed to guide treatment selection and sequence. In this review, we describe the key histologic features and molecular alterations of RCC subtypes and discuss emerging tissue-based biomarkers of response to currently available therapies for metastatic disease.

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