The impact of histology on survival for patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy

Alonso Carrasco, R. Houston Thompson, Bradley C. Leibovich, Christine M. Lohse, John C. Cheville, Stephen A. Boorjian

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To evaluate the impact of histology on cancer-specific and overall survival for patients with metastatic renal cell carcinoma (mRCC) undergoing cytoreductive nephrectomy (CN). Materials and Methods: We retrospectively reviewed the data of 505 patients with mRCC who underwent CN at Mayo Clinic, Rochester, MN, USA, between 1970 and 2008. All specimen were re-reviewed by a single genitourinary pathologist. Survival was estimated using the Kaplan-Meier method and compared according to histology with the log-rank test. Cox proportional hazard regression models were used to evaluate the association of histology with outcome. Results: Forty (8%) patients with non-clear cell histology and 465 (92%) patients with clear cell histology were identified. The median follow-up was 7.8 years. Metastatic non-clear cell histology was associated with a significantly older median age at nephrectomy (66 vs. 60 years; P = 0.002), larger median tumor size (11.5 vs. 9.2 cm; P = 0.02), and higher rate of lymph node involvement (50% vs. 16%; P < 0.001). No significant difference in 3-year cancer-specific survival (25% vs. 22%; P = 0.50) was noted between patients with clear cell and non-clear cell histology. On multivariate analysis, non-clear cell histology was not significantly associated with patients' risk of death from cancer (HR 0.96; 95% CI 0.61, 1.51; P = 0.85). Conclusions: Non-clear cell histology was not independently associated with adverse survival for patients with mRCC undergoing CN. As such, we advocate that surgical resection should continue to be considered in the multimodal treatment approach to these patients, while additional efforts to risk stratify and optimize management in this setting remain necessary.

Original languageEnglish (US)
Pages (from-to)38-42
Number of pages5
JournalIndian Journal of Urology
Volume30
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Nephrectomy
Renal Cell Carcinoma
Histology
Survival
Neoplasms
Combined Modality Therapy
Proportional Hazards Models
Multivariate Analysis
Lymph Nodes

Keywords

  • Histology
  • kidney cancer
  • metastasis
  • nephrectomy
  • renal cell carcinoma

ASJC Scopus subject areas

  • Urology

Cite this

The impact of histology on survival for patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy. / Carrasco, Alonso; Thompson, R. Houston; Leibovich, Bradley C.; Lohse, Christine M.; Cheville, John C.; Boorjian, Stephen A.

In: Indian Journal of Urology, Vol. 30, No. 1, 2014, p. 38-42.

Research output: Contribution to journalArticle

Carrasco, Alonso ; Thompson, R. Houston ; Leibovich, Bradley C. ; Lohse, Christine M. ; Cheville, John C. ; Boorjian, Stephen A. / The impact of histology on survival for patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy. In: Indian Journal of Urology. 2014 ; Vol. 30, No. 1. pp. 38-42.
@article{e854d12b0fb04752be780a6659c1581a,
title = "The impact of histology on survival for patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy",
abstract = "Objective: To evaluate the impact of histology on cancer-specific and overall survival for patients with metastatic renal cell carcinoma (mRCC) undergoing cytoreductive nephrectomy (CN). Materials and Methods: We retrospectively reviewed the data of 505 patients with mRCC who underwent CN at Mayo Clinic, Rochester, MN, USA, between 1970 and 2008. All specimen were re-reviewed by a single genitourinary pathologist. Survival was estimated using the Kaplan-Meier method and compared according to histology with the log-rank test. Cox proportional hazard regression models were used to evaluate the association of histology with outcome. Results: Forty (8{\%}) patients with non-clear cell histology and 465 (92{\%}) patients with clear cell histology were identified. The median follow-up was 7.8 years. Metastatic non-clear cell histology was associated with a significantly older median age at nephrectomy (66 vs. 60 years; P = 0.002), larger median tumor size (11.5 vs. 9.2 cm; P = 0.02), and higher rate of lymph node involvement (50{\%} vs. 16{\%}; P < 0.001). No significant difference in 3-year cancer-specific survival (25{\%} vs. 22{\%}; P = 0.50) was noted between patients with clear cell and non-clear cell histology. On multivariate analysis, non-clear cell histology was not significantly associated with patients' risk of death from cancer (HR 0.96; 95{\%} CI 0.61, 1.51; P = 0.85). Conclusions: Non-clear cell histology was not independently associated with adverse survival for patients with mRCC undergoing CN. As such, we advocate that surgical resection should continue to be considered in the multimodal treatment approach to these patients, while additional efforts to risk stratify and optimize management in this setting remain necessary.",
keywords = "Histology, kidney cancer, metastasis, nephrectomy, renal cell carcinoma",
author = "Alonso Carrasco and Thompson, {R. Houston} and Leibovich, {Bradley C.} and Lohse, {Christine M.} and Cheville, {John C.} and Boorjian, {Stephen A.}",
year = "2014",
doi = "10.4103/0970-1591.124204",
language = "English (US)",
volume = "30",
pages = "38--42",
journal = "Indian Journal of Urology",
issn = "0970-1591",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "1",

}

TY - JOUR

T1 - The impact of histology on survival for patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy

AU - Carrasco, Alonso

AU - Thompson, R. Houston

AU - Leibovich, Bradley C.

AU - Lohse, Christine M.

AU - Cheville, John C.

AU - Boorjian, Stephen A.

PY - 2014

Y1 - 2014

N2 - Objective: To evaluate the impact of histology on cancer-specific and overall survival for patients with metastatic renal cell carcinoma (mRCC) undergoing cytoreductive nephrectomy (CN). Materials and Methods: We retrospectively reviewed the data of 505 patients with mRCC who underwent CN at Mayo Clinic, Rochester, MN, USA, between 1970 and 2008. All specimen were re-reviewed by a single genitourinary pathologist. Survival was estimated using the Kaplan-Meier method and compared according to histology with the log-rank test. Cox proportional hazard regression models were used to evaluate the association of histology with outcome. Results: Forty (8%) patients with non-clear cell histology and 465 (92%) patients with clear cell histology were identified. The median follow-up was 7.8 years. Metastatic non-clear cell histology was associated with a significantly older median age at nephrectomy (66 vs. 60 years; P = 0.002), larger median tumor size (11.5 vs. 9.2 cm; P = 0.02), and higher rate of lymph node involvement (50% vs. 16%; P < 0.001). No significant difference in 3-year cancer-specific survival (25% vs. 22%; P = 0.50) was noted between patients with clear cell and non-clear cell histology. On multivariate analysis, non-clear cell histology was not significantly associated with patients' risk of death from cancer (HR 0.96; 95% CI 0.61, 1.51; P = 0.85). Conclusions: Non-clear cell histology was not independently associated with adverse survival for patients with mRCC undergoing CN. As such, we advocate that surgical resection should continue to be considered in the multimodal treatment approach to these patients, while additional efforts to risk stratify and optimize management in this setting remain necessary.

AB - Objective: To evaluate the impact of histology on cancer-specific and overall survival for patients with metastatic renal cell carcinoma (mRCC) undergoing cytoreductive nephrectomy (CN). Materials and Methods: We retrospectively reviewed the data of 505 patients with mRCC who underwent CN at Mayo Clinic, Rochester, MN, USA, between 1970 and 2008. All specimen were re-reviewed by a single genitourinary pathologist. Survival was estimated using the Kaplan-Meier method and compared according to histology with the log-rank test. Cox proportional hazard regression models were used to evaluate the association of histology with outcome. Results: Forty (8%) patients with non-clear cell histology and 465 (92%) patients with clear cell histology were identified. The median follow-up was 7.8 years. Metastatic non-clear cell histology was associated with a significantly older median age at nephrectomy (66 vs. 60 years; P = 0.002), larger median tumor size (11.5 vs. 9.2 cm; P = 0.02), and higher rate of lymph node involvement (50% vs. 16%; P < 0.001). No significant difference in 3-year cancer-specific survival (25% vs. 22%; P = 0.50) was noted between patients with clear cell and non-clear cell histology. On multivariate analysis, non-clear cell histology was not significantly associated with patients' risk of death from cancer (HR 0.96; 95% CI 0.61, 1.51; P = 0.85). Conclusions: Non-clear cell histology was not independently associated with adverse survival for patients with mRCC undergoing CN. As such, we advocate that surgical resection should continue to be considered in the multimodal treatment approach to these patients, while additional efforts to risk stratify and optimize management in this setting remain necessary.

KW - Histology

KW - kidney cancer

KW - metastasis

KW - nephrectomy

KW - renal cell carcinoma

UR - http://www.scopus.com/inward/record.url?scp=84934287350&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84934287350&partnerID=8YFLogxK

U2 - 10.4103/0970-1591.124204

DO - 10.4103/0970-1591.124204

M3 - Article

AN - SCOPUS:84934287350

VL - 30

SP - 38

EP - 42

JO - Indian Journal of Urology

JF - Indian Journal of Urology

SN - 0970-1591

IS - 1

ER -