Sarcomatoid features and lymph node-positive disease in chromophobe renal cell carcinoma

Authors

Alberto C. Pieretti, University of Texas MD Anderson Cancer Center
Mary E. Westerman, University of Texas MD Anderson Cancer Center
Alexandria Childs, University of Texas MD Anderson Cancer Center
Niki Millward, University of Texas MD Anderson Cancer Center
Daniel D. Shapiro, University of Texas MD Anderson Cancer Center
Kanishka Sircar, University of Texas MD Anderson Cancer Center
Priya Rao, University of Texas MD Anderson Cancer Center
Eric Jonasch, University of Texas MD Anderson Cancer Center
Matthew T. Campbell, University of Texas MD Anderson Cancer Center
Nizar M. Tannir, University of Texas MD Anderson Cancer Center
Surena F. Matin, University of Texas MD Anderson Cancer Center
Christopher G. Wood, University of Texas MD Anderson Cancer Center
Jose A. Karam, University of Texas MD Anderson Cancer Center

Document Type

Article

Publication Date

11-1-2021

Publication Title

Urologic oncology

Abstract

PURPOSE: The presence of sarcomatoid features and/or lymph node-positive disease may be associated with a worse prognosis in chromophobe renal cell carcinoma (ChRCC). We sought to better characterize patients' long-term outcomes with these features compared with those without these features. MATERIALS AND METHODS: We identified 300 patients treated for sporadic, unilateral, nonmetastatic ChRCC between 1993 and 2019. Clinical and pathologic features were summarized, and cancer-specific survival (CSS) and recurrence-free survival (RFS) were analyzed using Kaplan-Meier plots. Cox regression analysis was performed to determine factors associated with recurrence. Patients with sarcomatoid features and/or nodal disease were grouped as high-risk in a secondary analysis. RESULTS: The median age was 60 years, 43.7% were female, 29.3% had pT3/T4 disease, 3.3% had sarcomatoid features, and 4% had pathologic N1 disease. Sixteen patients were categorized as high-risk based on the presence of sarcomatoid features (n = 4), pathologic N1 disease (n = 6), or both (n = 6). There were 22 recurrences; the recurrence rate in the low-risk group was 4.9% and 50% in the high-risk group. 10-year RFS was 91.4% in the low-risk group and 34.4% in the high-risk group (P < 0.001). 10-year CSS was 96.4% in the low-risk group and 54.3% in the high-risk group (P < 0.001). In multivariable analysis, sarcomatoid features (HR 5.5, CI 1.5-20.2, P = 0.01) and pN1 disease (HR 16.5, CI 5.3-51.4, P < 0.0001) were independently associated with RFS. CONCLUSIONS: The presence of sarcomatoid features and/or lymph node-positive disease portends a poor prognosis in ChRCC. Further studies evaluating the impact of novel therapeutic agents in these patients are warranted.

First Page

790.e17

Last Page

790.e23

DOI

10.1016/j.urolonc.2021.06.016

Recommended Citation

Pieretti, Alberto C.; Westerman, Mary E.; Childs, Alexandria; Millward, Niki; Shapiro, Daniel D.; Sircar, Kanishka; Rao, Priya; Jonasch, Eric; Campbell, Matthew T.; Tannir, Nizar M.; Matin, Surena F.; Wood, Christopher G.; and Karam, Jose A., "Sarcomatoid features and lymph node-positive disease in chromophobe renal cell carcinoma" (2021). LSU-LCMC Cancer Center Faculty Publications. 10.
https://digitalscholar.lsuhsc.edu/llcc_facpubs/10
10.1016/j.urolonc.2021.06.016