Do Clear Cell Papillary Renal Cell Carcinomas Have Malignant Potential?

Area of Science:

• Uropathology
• Oncology
• Renal Cell Carcinoma Subtypes

Background:

• Clear cell papillary renal cell carcinoma (CCPRCC) is a distinct subtype of kidney cancer.
• Previous literature reported no recurrences or metastases in 268 cases.
• This study aimed to further evaluate the clinical behavior of CCPRCC.

Observation:

• Fifty-eight patients with CCPRCC and follow-up data were analyzed.
• The majority presented with early-stage disease (pT1).
• Treatments included nephrectomies, cryoablations, and cyst ablation with negative margins in most cases.

Findings:

• Only three patients had evidence of disease after treatment, with one case of presumed metastatic disease in a sarcomatoid variant.
• The vast majority of patients (55 out of 58) remained disease-free.
• The study supports the indolent nature of pure CCPRCC.

Implications:

• The findings suggest that CCPRCC exhibits low malignant potential.
• Renaming the entity to "clear cell papillary neoplasm of low malignant potential" may better reflect its biological behavior.
• This reclassification could impact clinical management and patient counseling for CCPRCC.