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Long-term oncological outcomes of cystic renal cell carcinoma according to the Bosniak classification

  • Urology - Original Paper
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Abstract

Objectives

To evaluate the prognostic role of the Bosniak classification on the long-term oncological outcomes of cystic renal cell carcinomas.

Material and method

In a national multicentric retrospective study, we included patients treated surgically for localized cystic RCC from 2000 to 2010. Patients with a follow-up of less than 4 years, benign tumors, and ablative treatments were excluded. The primary outcome was disease-free survival.

Results

152 patients met the inclusion criteria: Bosniak II (6%), III (53%), IV (41%), with a median follow-up of 61 (12–179) months. Characteristics of the population and the tumors were [median, (min–max)] age 57 (25–84) years old, tumor size 43 mm (20–280), RENAL score 7 (4–12), PADUA score 8 (5–14). Treatments were 55% partial nephrectomy, 45% radical nephrectomy, 74% open surgery, and 26% laparoscopy. In pathological report, cystic RCC were mainly of low grade (1–2, 77%) and low stage (pT1, 81%). The two main histological subtypes were conventional (56%) and papillary (23%) RCC. Staging at presentation and histological characteristics were similar between Bosniak III and IV, except for high grade which was more common in Bosniak IV (12 vs 36%, p < 0.01). The Bosniak classification was not predictive of the recurrence, as 5- and 10-year disease-free survival were similar in Bosniak III and IV (92% vs 92% and 84% vs 83%, p = 0.60).

Conclusion

The Bosniak classification is predictive of the risk of malignancy but not of the oncological prognosis. Regardless of the initial Bosniak categories, almost all cystic RCCs were of low stage/grade and had low long-term recurrence rate.

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Authors and Affiliations

  1. Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, 13005, Marseille, France

    R. Boissier & S. Chkir

  2. Urology Department, Bichat—Claude-Bernard, Paris, France

    I. Ouzaid

  3. Urology Department, Rouen University Hospital, Rouen, France

    F. X. Nouhaud & A. Giwerc

  4. Urology Department, Rennes University Hospital, Rennes, France

    Z. Khene & K. Bensalah

  5. Urology Department, Georges Pompidou University Hospital, Paris, France

    C. Dariane & A. Mejean

  6. Urology Department, Angers University Hospital, Angers, France

    S. Chelly & P. Bigot

  7. Urology Department, Bordeaux University Hospital, Bordeaux, France

    C. Allenet & J. C. Bernhard

  8. Urology Department, Grenoble University Hospital, La Tronche, France

    J. B. Lefrancq & J. A. Long

  9. Urology Department, Medipole, Cabestany, France

    P. Gimel

  10. Urology Department, Saint-Joseph Hospital, Marseille, France

    T. Bodin

  11. Pathology Department, Rennes University Hospital, Rennes, France

    N. Rioux-Leclercq

  12. Radiology Department, Georges Pompidou University Hospital, Paris, France

    J. M. Correas

  13. Oncology Department, Gustave Roussy Institute, Paris, France

    L. Albiges

  14. Urology Department, Clinique Jules Verne, Nantes, France

    J. F. Hetet

Authors
  1. R. Boissier
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  2. I. Ouzaid
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  3. F. X. Nouhaud
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  4. Z. Khene
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  5. C. Dariane
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  6. S. Chkir
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  7. S. Chelly
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  8. A. Giwerc
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  9. C. Allenet
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  11. P. Gimel
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  12. T. Bodin
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  14. J. M. Correas
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  15. L. Albiges
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  16. J. F. Hetet
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  17. P. Bigot
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  18. J. C. Bernhard
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  19. J. A. Long
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  20. A. Mejean
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  21. K. Bensalah
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for the AFU Committee of Urological Oncology

Contributions

RB had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Protocol/project development: Boissier, Bensalah. Data collection or management: Chkir. Chelly, Dariane, Khene, Giwerc, Allenet, Lefrancq, Gimel, Hetet. Data analysis: Boissier, Bensalah. Manuscript writing/editing: Boissier. Other (please specify briefly using 1 to 5 words): Critical revision of the manuscript for important intellectual content: Nouhaud, Bigot, Bernhard, Long, Gimel, Bodin, Ouzaid, Rioux-Leclercq, Correas, Albigès, Mejean.

Corresponding author

Correspondence to R. Boissier.

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Conflict of interest

Authors reported no conflict of interest regarding this study.

Research involving human participants and/or animals

All included patients had locally signed a consent for the use of clinical and follow-up data for research purposes. The study was approved by the ethics committee of Association Francaise d’Urologie.

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Boissier, R., Ouzaid, I., Nouhaud, F.X. et al. Long-term oncological outcomes of cystic renal cell carcinoma according to the Bosniak classification. Int Urol Nephrol 51, 951–958 (2019). https://doi.org/10.1007/s11255-019-02085-6

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  • DOI: https://doi.org/10.1007/s11255-019-02085-6

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