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Enhancing Prostate Tumor Biobanking Reliability with Improved Sampling Technique and Histological Characterization
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Enhancing Prostate Tumor Biobanking Reliability with Improved Sampling Technique and Histological Characterization

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Does histologic subtype affect oncologic outcomes after nephron-sparing surgery?

Maxime Crépel1, Hendrik Isbarn, Umberto Capitanio

  • 1Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada.

Urology
|July 25, 2009
PubMed
Summary
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Renal cell carcinoma (RCC) histologic subtypes do not impact cancer-specific mortality after nephron-sparing surgery (NSS). This finding supports using NSS for all subtypes when assessing cancer-specific mortality.

Area of Science:

  • Urology
  • Oncology
  • Nephrology

Background:

  • Renal cell carcinoma (RCC) histologic subtypes (HSs) are thought to have prognostic value.
  • Papillary RCC HS has been associated with a worse prognosis, sometimes leading to radical nephrectomy instead of nephron-sparing surgery (NSS).
  • The impact of HSs on cancer-specific mortality after NSS requires further investigation.

Purpose of the Study:

  • To determine if RCC histologic subtypes influence cancer-specific mortality following nephron-sparing surgery (NSS).
  • To evaluate the prognostic significance of different RCC HSs in the context of NSS outcomes.

Main Methods:

  • Utilized univariate and multivariate Cox regression models.
  • Analyzed data from 1205 patients with Stage T1N0M0 RCC treated with NSS between 1988 and 2004.

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  • Data sourced from 9 Surveillance, Epidemiology, and End Results (SEER) registries.

    • Main Results:

    • Cancer-specific mortality rates at 36 months post-NSS were 97.8% (clear cell), 100% (chromophobe), and 97.4% (papillary) RCC HS.
    • Univariate and multivariate analyses revealed no statistically significant differences in cancer-specific mortality based on HS.
    • The observed mortality rates did not show significant variation across the studied RCC histologic subtypes.

    Conclusions:

    • No significant difference in cancer-specific mortality was found among papillary, chromophobe, and clear cell RCC HSs after NSS.
    • The suggested more aggressive nature of papillary RCC HS did not translate to worse outcomes in this study.
    • Histologic subtype should not preclude the use of NSS when cancer-specific mortality is the primary endpoint.