Clinical Significance of Subclassification of Papillary Renal Cell Carcinoma: Comparison of Clinicopathologic Parameters and Oncologic Outcomes Between Papillary Histologic Subtypes 1 and 2 Using the Korean Renal Cell Carcinoma Database

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Abstract

Micro-Abstract

The aim of the present study was to investigate the clinical significance of the subclassification of papillary renal cell carcinoma (pRCC) in a multi-institutional study of 274 Korean patients with pRCC. Type 2 pRCC displayed more aggressive clinicopathologic characteristics; however, no significant differences in prognosis were found between types 1 and 2 pRCC. Among patients with pRCC, the pathologic T stage was the only prognosticator.

Introduction:

The aims of the present study were to compare the clinicopathologic characteristics between type 1 and type 2 papillary renal cell carcinoma (pRCC) and to evaluate the effect of the subclassification of pRCC on the oncologic outcomes after surgery.

Materials and Methods:

The records of 274 patients with pRCC in the Korean renal cell carcinoma (KORCC) database were included for evaluation. Of the 274 patients, 118 had type 1 pRCC and 156 had type 2 pRCC. The patient characteristics, including clinicopathologic parameters, were investigated, and the oncologic outcomes were evaluated.

Results:

The mean patient age was significantly older in the type 2 pRCC group. Compared with type 1 pRCC tumors, type 2 pRCC tumors were more often localized to the renal hilum (P = .030). Patients with type 2 pRCC had a greater incidence of Fuhrman grade 3 and 4 tumors than those with type 1 pRCC (78.8% vs. 22.8; P < .001). Tumor necrosis and capsular invasion were more frequently found in type 2 pRCC (P = .008 and P = .007, respectively). At a mean follow-up period of 38.0 months (interquartile range, 11.8-57.3 months), the subclassification of pRCC did not influence the prognosis of patients with pRCC.

Conclusion:

From the information available in the KORCC database, we identified significant differences in clinicopathologic variables, including age, Fuhrman grade, tumor location, tumor necrosis, and capsular invasion between type 1 and 2 pRCC. Although type 2 pRCC had more aggressive clinicopathologic characteristics, subclassification of pRCC did not affect the oncologic outcomes.

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