Pathologic T1 clear cell renal cell carcinoma: Insulin-like growth factor-I receptor expression and disease-specific survival

Alexander Parker, John C. Cheville, Michael L. Blute, Todd Igel, Christine M. Lohse, James R Cerhan

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

BACKGROUND. A proportion of patients diagnosed with pathologic T1 (pT1) clear cell renal cell carcinoma (CC-RCC) will experience disease progression and death after surgery, whereas the majority remain disease free. The authors conducted a case-cohort investigation to examine the association of insulin-like growth factor I receptor (IGF-IR) expression and disease-specific survival in patients who underwent surgery for pT1 CC-RCC. METHODS. Eligible patients included those diagnosed with solitary, nonfamilial pT1 CC-RCC who underwent radical nephrectomy at the Mayo Clinic-Rochester between 1970 and 2000 (n = 886 patients). Among this group, 136 patients died of CC-RCC (cases). Archived tumor blocks were not available for 62 patients, leaving a final study group of 74 cases. Stratified, random sampling was used to select a cohort of at least 3 year-matched controls (no CC-RCC death) for each case (n = 263 patients). Detection of IGF-IR was performed using a commercially available monoclonal antibody. Cox proportional hazards models were fit to assess the association between IGF-IR expression and disease-specific survival. RESULTS. After adjustment for age, the risk of death from CC-RCC was greater for patients who had tumors that stained positive for IGF-IR compared with patients who had tumors that showed no IGF-IR expression (hazard ratio [HR], 1.5; 95% confidence interval, [95% CI], 0.9-2.4). In a stratified analysis, the risk was stronger among patients who had high-grade tumors (HR, 2.2; 95% CI, 1.1-4.3) compared with patients who had low-grade tumors (HR, 0.7; 95% CI, 0.3-1.5). Multivariate adjustment for tumor size and histologic tumor necrosis attenuated the association among all patients (HR, 1.3; 95% CI, 0.8-2.1) but strengthened the association among patients with high-grade tumors (HR, 2.7; 95% CI, 1.3-5.6). CONCLUSIONS. The current data suggest that IGF-IR expression is associated with poor survival in patients who are diagnosed with early-stage CC-RCC, especially among those with high-grade disease.

Original languageEnglish (US)
Pages (from-to)2577-2582
Number of pages6
JournalCancer
Volume100
Issue number12
DOIs
StatePublished - Jun 15 2004

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IGF Type 1 Receptor
Renal Cell Carcinoma
Survival
Confidence Intervals
Neoplasms
Risk Adjustment
Nephrectomy
Proportional Hazards Models
Disease Progression

Keywords

  • Clear cell renal cell carcinoma
  • Disease stage
  • Disease-specific survival
  • Insulin-like growth factor I receptor

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Pathologic T1 clear cell renal cell carcinoma : Insulin-like growth factor-I receptor expression and disease-specific survival. / Parker, Alexander; Cheville, John C.; Blute, Michael L.; Igel, Todd; Lohse, Christine M.; Cerhan, James R.

In: Cancer, Vol. 100, No. 12, 15.06.2004, p. 2577-2582.

Research output: Contribution to journalArticle

Parker, Alexander ; Cheville, John C. ; Blute, Michael L. ; Igel, Todd ; Lohse, Christine M. ; Cerhan, James R. / Pathologic T1 clear cell renal cell carcinoma : Insulin-like growth factor-I receptor expression and disease-specific survival. In: Cancer. 2004 ; Vol. 100, No. 12. pp. 2577-2582.
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title = "Pathologic T1 clear cell renal cell carcinoma: Insulin-like growth factor-I receptor expression and disease-specific survival",
abstract = "BACKGROUND. A proportion of patients diagnosed with pathologic T1 (pT1) clear cell renal cell carcinoma (CC-RCC) will experience disease progression and death after surgery, whereas the majority remain disease free. The authors conducted a case-cohort investigation to examine the association of insulin-like growth factor I receptor (IGF-IR) expression and disease-specific survival in patients who underwent surgery for pT1 CC-RCC. METHODS. Eligible patients included those diagnosed with solitary, nonfamilial pT1 CC-RCC who underwent radical nephrectomy at the Mayo Clinic-Rochester between 1970 and 2000 (n = 886 patients). Among this group, 136 patients died of CC-RCC (cases). Archived tumor blocks were not available for 62 patients, leaving a final study group of 74 cases. Stratified, random sampling was used to select a cohort of at least 3 year-matched controls (no CC-RCC death) for each case (n = 263 patients). Detection of IGF-IR was performed using a commercially available monoclonal antibody. Cox proportional hazards models were fit to assess the association between IGF-IR expression and disease-specific survival. RESULTS. After adjustment for age, the risk of death from CC-RCC was greater for patients who had tumors that stained positive for IGF-IR compared with patients who had tumors that showed no IGF-IR expression (hazard ratio [HR], 1.5; 95{\%} confidence interval, [95{\%} CI], 0.9-2.4). In a stratified analysis, the risk was stronger among patients who had high-grade tumors (HR, 2.2; 95{\%} CI, 1.1-4.3) compared with patients who had low-grade tumors (HR, 0.7; 95{\%} CI, 0.3-1.5). Multivariate adjustment for tumor size and histologic tumor necrosis attenuated the association among all patients (HR, 1.3; 95{\%} CI, 0.8-2.1) but strengthened the association among patients with high-grade tumors (HR, 2.7; 95{\%} CI, 1.3-5.6). CONCLUSIONS. The current data suggest that IGF-IR expression is associated with poor survival in patients who are diagnosed with early-stage CC-RCC, especially among those with high-grade disease.",
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T1 - Pathologic T1 clear cell renal cell carcinoma

T2 - Insulin-like growth factor-I receptor expression and disease-specific survival

AU - Parker, Alexander

AU - Cheville, John C.

AU - Blute, Michael L.

AU - Igel, Todd

AU - Lohse, Christine M.

AU - Cerhan, James R

PY - 2004/6/15

Y1 - 2004/6/15

N2 - BACKGROUND. A proportion of patients diagnosed with pathologic T1 (pT1) clear cell renal cell carcinoma (CC-RCC) will experience disease progression and death after surgery, whereas the majority remain disease free. The authors conducted a case-cohort investigation to examine the association of insulin-like growth factor I receptor (IGF-IR) expression and disease-specific survival in patients who underwent surgery for pT1 CC-RCC. METHODS. Eligible patients included those diagnosed with solitary, nonfamilial pT1 CC-RCC who underwent radical nephrectomy at the Mayo Clinic-Rochester between 1970 and 2000 (n = 886 patients). Among this group, 136 patients died of CC-RCC (cases). Archived tumor blocks were not available for 62 patients, leaving a final study group of 74 cases. Stratified, random sampling was used to select a cohort of at least 3 year-matched controls (no CC-RCC death) for each case (n = 263 patients). Detection of IGF-IR was performed using a commercially available monoclonal antibody. Cox proportional hazards models were fit to assess the association between IGF-IR expression and disease-specific survival. RESULTS. After adjustment for age, the risk of death from CC-RCC was greater for patients who had tumors that stained positive for IGF-IR compared with patients who had tumors that showed no IGF-IR expression (hazard ratio [HR], 1.5; 95% confidence interval, [95% CI], 0.9-2.4). In a stratified analysis, the risk was stronger among patients who had high-grade tumors (HR, 2.2; 95% CI, 1.1-4.3) compared with patients who had low-grade tumors (HR, 0.7; 95% CI, 0.3-1.5). Multivariate adjustment for tumor size and histologic tumor necrosis attenuated the association among all patients (HR, 1.3; 95% CI, 0.8-2.1) but strengthened the association among patients with high-grade tumors (HR, 2.7; 95% CI, 1.3-5.6). CONCLUSIONS. The current data suggest that IGF-IR expression is associated with poor survival in patients who are diagnosed with early-stage CC-RCC, especially among those with high-grade disease.

AB - BACKGROUND. A proportion of patients diagnosed with pathologic T1 (pT1) clear cell renal cell carcinoma (CC-RCC) will experience disease progression and death after surgery, whereas the majority remain disease free. The authors conducted a case-cohort investigation to examine the association of insulin-like growth factor I receptor (IGF-IR) expression and disease-specific survival in patients who underwent surgery for pT1 CC-RCC. METHODS. Eligible patients included those diagnosed with solitary, nonfamilial pT1 CC-RCC who underwent radical nephrectomy at the Mayo Clinic-Rochester between 1970 and 2000 (n = 886 patients). Among this group, 136 patients died of CC-RCC (cases). Archived tumor blocks were not available for 62 patients, leaving a final study group of 74 cases. Stratified, random sampling was used to select a cohort of at least 3 year-matched controls (no CC-RCC death) for each case (n = 263 patients). Detection of IGF-IR was performed using a commercially available monoclonal antibody. Cox proportional hazards models were fit to assess the association between IGF-IR expression and disease-specific survival. RESULTS. After adjustment for age, the risk of death from CC-RCC was greater for patients who had tumors that stained positive for IGF-IR compared with patients who had tumors that showed no IGF-IR expression (hazard ratio [HR], 1.5; 95% confidence interval, [95% CI], 0.9-2.4). In a stratified analysis, the risk was stronger among patients who had high-grade tumors (HR, 2.2; 95% CI, 1.1-4.3) compared with patients who had low-grade tumors (HR, 0.7; 95% CI, 0.3-1.5). Multivariate adjustment for tumor size and histologic tumor necrosis attenuated the association among all patients (HR, 1.3; 95% CI, 0.8-2.1) but strengthened the association among patients with high-grade tumors (HR, 2.7; 95% CI, 1.3-5.6). CONCLUSIONS. The current data suggest that IGF-IR expression is associated with poor survival in patients who are diagnosed with early-stage CC-RCC, especially among those with high-grade disease.

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KW - Disease stage

KW - Disease-specific survival

KW - Insulin-like growth factor I receptor

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