Impact of histologic subtype on cancer-specific survival in patients with renal cell carcinoma and tumor thrombus

Derya Tilki, Hao G. Nguyen, Marc A. Dall'Era, Roberto Bertini, Joaquín A. Carballido, Thomas Chromecki, Gaetano Ciancio, Siamak Daneshmand, Paolo Gontero, Javier Gonzalez, Axel Haferkamp, Markus Hohenfellner, William C. Huang, Theresa M. Koppie, C. Adam Lorentz, Philipp Mandel, Juan I. Martinez-Salamanca, Viraj A. Master, Rayan Matloob, James M. McKiernanCarrie M. Mlynarczyk, Francesco Montorsi, Giacomo Novara, Sascha Pahernik, Juan Palou, Raj S. Pruthi, Krishna Ramaswamy, Oscar Rodriguez Faba, Paul Russo, Shahrokh F. Shariat, Martin Spahn, Carlo Terrone, Daniel Vergho, Eric M. Wallen, Evanguelos Xylinas, Richard Zigeuner, John A. Libertino, Christopher P. Evans

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background Although different prognostic factors for patients with renal cell carcinoma (RCC) and vena cava tumor thrombus (TT) have been studied, the prognostic value of histologic subtype in these patients remains unclear. Objective We analyzed the impact of histologic subtype on cancer-specific survival (CSS). Design, settings, and participants We retrospectively analyzed the records of 1774 patients with RCC and TT who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 US and European centers. Outcome measurements and statistical analysis Multivariable ordered logistic and Cox regression models were used to quantify the impact of tumor histology on CSS. Results and limitations Overall 5-yr CSS was 53.4% (confidence interval [CI], 50.5-56.2) in the entire group. TT level (according to the Mayo classification of macroscopic venous invasion in RCC) was I in 38.5% of patients, II in 30.6%, III in 17.3%, and IV in 13.5%. Histologic subtypes were clear cell renal cell carcinoma (cRCC) in 89.9% of patients, papillary renal cell carcinoma (pRCC) in 8.5%, and chromophobe RCC in 1.6%. In univariable analysis, pRCC was associated with a significantly worse CSS (p < 0.001) compared with cRCC. In multivariable analysis, the presence of pRCC was independently associated with CSS (hazard ratio: 1.62; CI, 1.01-2.61; p < 0.05). Higher TT level, positive lymph node status, distant metastasis, and fat invasion were also independently associated with CSS. Conclusions In our multi-institutional series, we found that patients with pRCC and vena cava TT who underwent radical nephrectomy and tumor thrombectomy had significantly worse cancer-specific outcomes when compared with patients with other histologic subtypes of RCC. We confirmed that higher TT level and fat invasion were independently associated with reduced CSS.

Original languageEnglish
Pages (from-to)577-583
Number of pages7
JournalEuropean Urology
Volume66
Issue number3
DOIs
StatePublished - Jan 1 2014

Fingerprint

Renal Cell Carcinoma
Thrombosis
Survival
Neoplasms
Thrombectomy
Venae Cavae
Nephrectomy
Fats
Confidence Intervals
Proportional Hazards Models

Keywords

  • Clear cell
  • Histology
  • Papillary
  • Prognosis
  • Renal cell carcinoma
  • Survival
  • Vena cava tumor thrombus

ASJC Scopus subject areas

  • Urology

Cite this

Tilki, D., Nguyen, H. G., Dall'Era, M. A., Bertini, R., Carballido, J. A., Chromecki, T., ... Evans, C. P. (2014). Impact of histologic subtype on cancer-specific survival in patients with renal cell carcinoma and tumor thrombus. European Urology, 66(3), 577-583. https://doi.org/10.1016/j.eururo.2013.06.048

Impact of histologic subtype on cancer-specific survival in patients with renal cell carcinoma and tumor thrombus. / Tilki, Derya; Nguyen, Hao G.; Dall'Era, Marc A.; Bertini, Roberto; Carballido, Joaquín A.; Chromecki, Thomas; Ciancio, Gaetano; Daneshmand, Siamak; Gontero, Paolo; Gonzalez, Javier; Haferkamp, Axel; Hohenfellner, Markus; Huang, William C.; Koppie, Theresa M.; Lorentz, C. Adam; Mandel, Philipp; Martinez-Salamanca, Juan I.; Master, Viraj A.; Matloob, Rayan; McKiernan, James M.; Mlynarczyk, Carrie M.; Montorsi, Francesco; Novara, Giacomo; Pahernik, Sascha; Palou, Juan; Pruthi, Raj S.; Ramaswamy, Krishna; Rodriguez Faba, Oscar; Russo, Paul; Shariat, Shahrokh F.; Spahn, Martin; Terrone, Carlo; Vergho, Daniel; Wallen, Eric M.; Xylinas, Evanguelos; Zigeuner, Richard; Libertino, John A.; Evans, Christopher P.

In: European Urology, Vol. 66, No. 3, 01.01.2014, p. 577-583.

Research output: Contribution to journalArticle

Tilki, D, Nguyen, HG, Dall'Era, MA, Bertini, R, Carballido, JA, Chromecki, T, Ciancio, G, Daneshmand, S, Gontero, P, Gonzalez, J, Haferkamp, A, Hohenfellner, M, Huang, WC, Koppie, TM, Lorentz, CA, Mandel, P, Martinez-Salamanca, JI, Master, VA, Matloob, R, McKiernan, JM, Mlynarczyk, CM, Montorsi, F, Novara, G, Pahernik, S, Palou, J, Pruthi, RS, Ramaswamy, K, Rodriguez Faba, O, Russo, P, Shariat, SF, Spahn, M, Terrone, C, Vergho, D, Wallen, EM, Xylinas, E, Zigeuner, R, Libertino, JA & Evans, CP 2014, 'Impact of histologic subtype on cancer-specific survival in patients with renal cell carcinoma and tumor thrombus', European Urology, vol. 66, no. 3, pp. 577-583. https://doi.org/10.1016/j.eururo.2013.06.048
Tilki, Derya ; Nguyen, Hao G. ; Dall'Era, Marc A. ; Bertini, Roberto ; Carballido, Joaquín A. ; Chromecki, Thomas ; Ciancio, Gaetano ; Daneshmand, Siamak ; Gontero, Paolo ; Gonzalez, Javier ; Haferkamp, Axel ; Hohenfellner, Markus ; Huang, William C. ; Koppie, Theresa M. ; Lorentz, C. Adam ; Mandel, Philipp ; Martinez-Salamanca, Juan I. ; Master, Viraj A. ; Matloob, Rayan ; McKiernan, James M. ; Mlynarczyk, Carrie M. ; Montorsi, Francesco ; Novara, Giacomo ; Pahernik, Sascha ; Palou, Juan ; Pruthi, Raj S. ; Ramaswamy, Krishna ; Rodriguez Faba, Oscar ; Russo, Paul ; Shariat, Shahrokh F. ; Spahn, Martin ; Terrone, Carlo ; Vergho, Daniel ; Wallen, Eric M. ; Xylinas, Evanguelos ; Zigeuner, Richard ; Libertino, John A. ; Evans, Christopher P. / Impact of histologic subtype on cancer-specific survival in patients with renal cell carcinoma and tumor thrombus. In: European Urology. 2014 ; Vol. 66, No. 3. pp. 577-583.
@article{a24368ba301841bd9a15aba2e41d2056,
title = "Impact of histologic subtype on cancer-specific survival in patients with renal cell carcinoma and tumor thrombus",
abstract = "Background Although different prognostic factors for patients with renal cell carcinoma (RCC) and vena cava tumor thrombus (TT) have been studied, the prognostic value of histologic subtype in these patients remains unclear. Objective We analyzed the impact of histologic subtype on cancer-specific survival (CSS). Design, settings, and participants We retrospectively analyzed the records of 1774 patients with RCC and TT who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 US and European centers. Outcome measurements and statistical analysis Multivariable ordered logistic and Cox regression models were used to quantify the impact of tumor histology on CSS. Results and limitations Overall 5-yr CSS was 53.4{\%} (confidence interval [CI], 50.5-56.2) in the entire group. TT level (according to the Mayo classification of macroscopic venous invasion in RCC) was I in 38.5{\%} of patients, II in 30.6{\%}, III in 17.3{\%}, and IV in 13.5{\%}. Histologic subtypes were clear cell renal cell carcinoma (cRCC) in 89.9{\%} of patients, papillary renal cell carcinoma (pRCC) in 8.5{\%}, and chromophobe RCC in 1.6{\%}. In univariable analysis, pRCC was associated with a significantly worse CSS (p < 0.001) compared with cRCC. In multivariable analysis, the presence of pRCC was independently associated with CSS (hazard ratio: 1.62; CI, 1.01-2.61; p < 0.05). Higher TT level, positive lymph node status, distant metastasis, and fat invasion were also independently associated with CSS. Conclusions In our multi-institutional series, we found that patients with pRCC and vena cava TT who underwent radical nephrectomy and tumor thrombectomy had significantly worse cancer-specific outcomes when compared with patients with other histologic subtypes of RCC. We confirmed that higher TT level and fat invasion were independently associated with reduced CSS.",
keywords = "Clear cell, Histology, Papillary, Prognosis, Renal cell carcinoma, Survival, Vena cava tumor thrombus",
author = "Derya Tilki and Nguyen, {Hao G.} and Dall'Era, {Marc A.} and Roberto Bertini and Carballido, {Joaqu{\'i}n A.} and Thomas Chromecki and Gaetano Ciancio and Siamak Daneshmand and Paolo Gontero and Javier Gonzalez and Axel Haferkamp and Markus Hohenfellner and Huang, {William C.} and Koppie, {Theresa M.} and Lorentz, {C. Adam} and Philipp Mandel and Martinez-Salamanca, {Juan I.} and Master, {Viraj A.} and Rayan Matloob and McKiernan, {James M.} and Mlynarczyk, {Carrie M.} and Francesco Montorsi and Giacomo Novara and Sascha Pahernik and Juan Palou and Pruthi, {Raj S.} and Krishna Ramaswamy and {Rodriguez Faba}, Oscar and Paul Russo and Shariat, {Shahrokh F.} and Martin Spahn and Carlo Terrone and Daniel Vergho and Wallen, {Eric M.} and Evanguelos Xylinas and Richard Zigeuner and Libertino, {John A.} and Evans, {Christopher P.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1016/j.eururo.2013.06.048",
language = "English",
volume = "66",
pages = "577--583",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - Impact of histologic subtype on cancer-specific survival in patients with renal cell carcinoma and tumor thrombus

AU - Tilki, Derya

AU - Nguyen, Hao G.

AU - Dall'Era, Marc A.

AU - Bertini, Roberto

AU - Carballido, Joaquín A.

AU - Chromecki, Thomas

AU - Ciancio, Gaetano

AU - Daneshmand, Siamak

AU - Gontero, Paolo

AU - Gonzalez, Javier

AU - Haferkamp, Axel

AU - Hohenfellner, Markus

AU - Huang, William C.

AU - Koppie, Theresa M.

AU - Lorentz, C. Adam

AU - Mandel, Philipp

AU - Martinez-Salamanca, Juan I.

AU - Master, Viraj A.

AU - Matloob, Rayan

AU - McKiernan, James M.

AU - Mlynarczyk, Carrie M.

AU - Montorsi, Francesco

AU - Novara, Giacomo

AU - Pahernik, Sascha

AU - Palou, Juan

AU - Pruthi, Raj S.

AU - Ramaswamy, Krishna

AU - Rodriguez Faba, Oscar

AU - Russo, Paul

AU - Shariat, Shahrokh F.

AU - Spahn, Martin

AU - Terrone, Carlo

AU - Vergho, Daniel

AU - Wallen, Eric M.

AU - Xylinas, Evanguelos

AU - Zigeuner, Richard

AU - Libertino, John A.

AU - Evans, Christopher P.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background Although different prognostic factors for patients with renal cell carcinoma (RCC) and vena cava tumor thrombus (TT) have been studied, the prognostic value of histologic subtype in these patients remains unclear. Objective We analyzed the impact of histologic subtype on cancer-specific survival (CSS). Design, settings, and participants We retrospectively analyzed the records of 1774 patients with RCC and TT who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 US and European centers. Outcome measurements and statistical analysis Multivariable ordered logistic and Cox regression models were used to quantify the impact of tumor histology on CSS. Results and limitations Overall 5-yr CSS was 53.4% (confidence interval [CI], 50.5-56.2) in the entire group. TT level (according to the Mayo classification of macroscopic venous invasion in RCC) was I in 38.5% of patients, II in 30.6%, III in 17.3%, and IV in 13.5%. Histologic subtypes were clear cell renal cell carcinoma (cRCC) in 89.9% of patients, papillary renal cell carcinoma (pRCC) in 8.5%, and chromophobe RCC in 1.6%. In univariable analysis, pRCC was associated with a significantly worse CSS (p < 0.001) compared with cRCC. In multivariable analysis, the presence of pRCC was independently associated with CSS (hazard ratio: 1.62; CI, 1.01-2.61; p < 0.05). Higher TT level, positive lymph node status, distant metastasis, and fat invasion were also independently associated with CSS. Conclusions In our multi-institutional series, we found that patients with pRCC and vena cava TT who underwent radical nephrectomy and tumor thrombectomy had significantly worse cancer-specific outcomes when compared with patients with other histologic subtypes of RCC. We confirmed that higher TT level and fat invasion were independently associated with reduced CSS.

AB - Background Although different prognostic factors for patients with renal cell carcinoma (RCC) and vena cava tumor thrombus (TT) have been studied, the prognostic value of histologic subtype in these patients remains unclear. Objective We analyzed the impact of histologic subtype on cancer-specific survival (CSS). Design, settings, and participants We retrospectively analyzed the records of 1774 patients with RCC and TT who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 US and European centers. Outcome measurements and statistical analysis Multivariable ordered logistic and Cox regression models were used to quantify the impact of tumor histology on CSS. Results and limitations Overall 5-yr CSS was 53.4% (confidence interval [CI], 50.5-56.2) in the entire group. TT level (according to the Mayo classification of macroscopic venous invasion in RCC) was I in 38.5% of patients, II in 30.6%, III in 17.3%, and IV in 13.5%. Histologic subtypes were clear cell renal cell carcinoma (cRCC) in 89.9% of patients, papillary renal cell carcinoma (pRCC) in 8.5%, and chromophobe RCC in 1.6%. In univariable analysis, pRCC was associated with a significantly worse CSS (p < 0.001) compared with cRCC. In multivariable analysis, the presence of pRCC was independently associated with CSS (hazard ratio: 1.62; CI, 1.01-2.61; p < 0.05). Higher TT level, positive lymph node status, distant metastasis, and fat invasion were also independently associated with CSS. Conclusions In our multi-institutional series, we found that patients with pRCC and vena cava TT who underwent radical nephrectomy and tumor thrombectomy had significantly worse cancer-specific outcomes when compared with patients with other histologic subtypes of RCC. We confirmed that higher TT level and fat invasion were independently associated with reduced CSS.

KW - Clear cell

KW - Histology

KW - Papillary

KW - Prognosis

KW - Renal cell carcinoma

KW - Survival

KW - Vena cava tumor thrombus

UR - http://www.scopus.com/inward/record.url?scp=84905918842&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905918842&partnerID=8YFLogxK

U2 - 10.1016/j.eururo.2013.06.048

DO - 10.1016/j.eururo.2013.06.048

M3 - Article

C2 - 23871402

AN - SCOPUS:84905918842

VL - 66

SP - 577

EP - 583

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 3

ER -