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Clinically localized type 1 and 2 papillary renal cell carcinomas have similar survival outcomes following surgery

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Abstract

Purpose

We aimed to determine incidence, pathologic findings, prognostic factors and clinical outcomes for patients with clinically localized papillary RCC.

Methods

Demographic, clinical and pathologic findings were collected on all patients with PRCC undergoing surgery at four academic medical centers. The primary endpoint was cancer-specific survival (CSS). Relapse-free survival (RFS) and overall survival (OS) were secondary endpoints. Kaplan–Meier estimates were obtained, and Cox proportional hazard regression models were used to assess predictors of mortality and relapse.

Results

We identified 626 PRCC, of which 373 (60 %) were type 1 and 253 (40 %) were type 2, with three-quarters of all tumors being pT1. Compared to patients with type 1, those with type 2 were older (mean age: 63 vs 61; p = 0.02), presented more commonly with symptoms (13 vs 7 %; p = 0.02) and had larger mean tumor size (5.2 vs 4.3 cm; p = 0.001). With a median follow-up of 41 months (IQR: 16–68), 92 patients had died of PRCC (15 %), 48 (8 %) experienced relapse, and 101 died from all causes (16 %). The estimated 5-year CSS, RFS and OS were 83, 91 and 82 %, respectively. In multivariable analysis, older age, T stage and nodal status were predictors of CSS and OS. However, PRCC subtype was not a predictor of CSS, RFS or OS.

Conclusion

While patients with type 2 PRCC appear to present with more advanced disease than patients with type 1, PRCC subtype does not appear to be an independent predictor of CSS, RFS or OS for treated localized disease.

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Abbreviations

PRCC:

Papillary renal cell carcinoma

CSS:

Cancer-specific survival

RFS:

Relapse-free survival

OS:

Overall survival

HR:

Hazard ratio

SD:

Standard deviation

CI:

Confidence interval

IQR:

Interquartile range

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Authors’ contribution

Ledezma involved in protocol and project development, data collection, data management and data analysis, wrote and edited the manuscript. Negron involved in data collection or management. Paner involved in project development and data collection. Rjepaj involved in data collection or management. Lascano involved in data collection or management. Haseebuddin involved in data collection or management. Dangle involved in data collection or management. Shalhav involved in protocol/project development, wrote and edited the manuscript. Crist involved in data collection or management. Raman involved in protocol/project development, wrote and edited the manuscript. DeCastro involved in protocol/project development, wrote and edited the manuscript. Harik involved in data collection or management. Paroder involved in data collection or management. Uzzo wrote and edited the manuscript. Kutikov wrote and edited the manuscript. Eggener involved in protocol/project development and data analysis, wrote and edited the manuscript.

Author information

Authors and Affiliations

  1. Section of Urology, Department of Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC6038, J-664, Chicago, IL, 60637, USA

    Rodrigo A. Ledezma, Edris Negron, Pankaj Dangle, Arieh L. Shalhav & Scott E. Eggener

  2. Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA

    Gladell P. Paner

  3. Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA

    Chris Rjepaj & Jay D. Raman

  4. Department of Urology, Columbia University, New York, NY, USA

    Danny Lascano & G. Joel DeCastro

  5. Division of Urologic Oncology, Fox Chase Cancer Center Temple University Health System, Philadelphia, PA, USA

    Mohammed Haseebuddin, Robert G. Uzzo & Alexander Kutikov

  6. Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA

    Henry Crist

  7. Department of Pathology, Columbia University, New York, NY, USA

    Lara Harik & Monika Paroder

Authors
  1. Rodrigo A. Ledezma
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  2. Edris Negron
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  3. Gladell P. Paner
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  7. Pankaj Dangle
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  8. Arieh L. Shalhav
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  9. Henry Crist
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  10. Jay D. Raman
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  11. G. Joel DeCastro
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  12. Lara Harik
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  13. Monika Paroder
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  14. Robert G. Uzzo
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  15. Alexander Kutikov
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  16. Scott E. Eggener
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Corresponding author

Correspondence to Rodrigo A. Ledezma.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The manuscript entitled “Clinically Localized Type 1 and 2 Papillary Renal Cell Carcinomas Have Similar Survival Outcomes Following Surgery” was an investigation approved by the Internal Board Review Committee of the University of Chicago (IRB number # 13-0461). Therefore, the manuscript has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

In addition, all patients gave their informed consent prior to their inclusion in the study.

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Ledezma, R.A., Negron, E., Paner, G.P. et al. Clinically localized type 1 and 2 papillary renal cell carcinomas have similar survival outcomes following surgery. World J Urol 34, 687–693 (2016). https://doi.org/10.1007/s00345-015-1692-3

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  • DOI: https://doi.org/10.1007/s00345-015-1692-3

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