Cancer specific mortality in patients with collecting duct vs. clear cell renal carcinoma
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Cancer specific mortality in patients with collecting duct vs. clear cell renal carcinoma. / Panunzio, Andrea; Sorce, Gabriele; Tappero, Stefano; Hohenhorst, Lukas; Garcia, Cristina Cano; Piccinelli, Mattia; Tian, Zhe; Tafuri, Alessandro; De Cobelli, Ottavio; Chun, Felix K H; Tilki, Derya; Terrone, Carlo; Briganti, Alberto; Kapoor, Anil; Saad, Fred; Shariat, Shahrokh F; Cerruto, Maria Angela; Antonelli, Alessandro; Karakiewicz, Pierre I.
in: CANCER EPIDEMIOL, Jahrgang 82, 02.2023, S. 102297.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Cancer specific mortality in patients with collecting duct vs. clear cell renal carcinoma
AU - Panunzio, Andrea
AU - Sorce, Gabriele
AU - Tappero, Stefano
AU - Hohenhorst, Lukas
AU - Garcia, Cristina Cano
AU - Piccinelli, Mattia
AU - Tian, Zhe
AU - Tafuri, Alessandro
AU - De Cobelli, Ottavio
AU - Chun, Felix K H
AU - Tilki, Derya
AU - Terrone, Carlo
AU - Briganti, Alberto
AU - Kapoor, Anil
AU - Saad, Fred
AU - Shariat, Shahrokh F
AU - Cerruto, Maria Angela
AU - Antonelli, Alessandro
AU - Karakiewicz, Pierre I
N1 - Copyright © 2022 Elsevier Ltd. All rights reserved.
PY - 2023/2
Y1 - 2023/2
N2 - BACKGROUND: Collecting duct carcinoma (CDC) is biologically more aggressive than clear cell renal cell carcinoma (ccRCC). We tested for differences in cancer specific mortality (CSM) rates according to CDC vs. ISUP (International Society of Urological Pathology) 4 ccRCC histological subtype. We hypothesized that the survival disadvantage still applies, even after most detailed adjustments.METHODS: Within Surveillance, Epidemiology, and End Results database (2004-2018), we identified 380 CDC vs. 6273 ISUP 4 ccRCC patients of all stages. Propensity score matching (age, sex, race/ethnicity, T, N, and M stages, nephrectomy, and systemic therapy status), Kaplan-Meier plots and multivariable Cox regression models were used.RESULTS: All 380 CDC were matched (1:2) with 760 ISUP4 ccRCC patients. Prior to matching CDC patients exhibited higher rates of lymph node invasion (37.6 % vs. 14.7 %, p < 0.001), and of distant metastases (40.8 % vs. 30.4 %, p < 0.001). Systemic therapy rates were higher in CDC (29.5 % vs. 20.5 %, p < 0.001). However, nephrectomy rates were higher in ISUP4 ccRCC patients (97.5 % vs. 84.7 %, p < 0.001). After matching, in multivariable Cox regression models addressing CSM, CDC was associated with a HR of 1.5 (p < 0.001) in the overall population vs. 1.9 (p = 0.014) in stage I-II vs. 1.4 (p = 0.022) in stage III vs. 1.6 in stage IV (p < 0.001), relative to ISUP4 ccRCC.CONCLUSION: CDC patients exhibited 40-90 % higher CSM than their ISUP4 ccRCC counterparts in the overall analysis, as well as in stage specific analyses. The CSM disadvantage applies despite higher rates of systemic therapy in CDC patients.
AB - BACKGROUND: Collecting duct carcinoma (CDC) is biologically more aggressive than clear cell renal cell carcinoma (ccRCC). We tested for differences in cancer specific mortality (CSM) rates according to CDC vs. ISUP (International Society of Urological Pathology) 4 ccRCC histological subtype. We hypothesized that the survival disadvantage still applies, even after most detailed adjustments.METHODS: Within Surveillance, Epidemiology, and End Results database (2004-2018), we identified 380 CDC vs. 6273 ISUP 4 ccRCC patients of all stages. Propensity score matching (age, sex, race/ethnicity, T, N, and M stages, nephrectomy, and systemic therapy status), Kaplan-Meier plots and multivariable Cox regression models were used.RESULTS: All 380 CDC were matched (1:2) with 760 ISUP4 ccRCC patients. Prior to matching CDC patients exhibited higher rates of lymph node invasion (37.6 % vs. 14.7 %, p < 0.001), and of distant metastases (40.8 % vs. 30.4 %, p < 0.001). Systemic therapy rates were higher in CDC (29.5 % vs. 20.5 %, p < 0.001). However, nephrectomy rates were higher in ISUP4 ccRCC patients (97.5 % vs. 84.7 %, p < 0.001). After matching, in multivariable Cox regression models addressing CSM, CDC was associated with a HR of 1.5 (p < 0.001) in the overall population vs. 1.9 (p = 0.014) in stage I-II vs. 1.4 (p = 0.022) in stage III vs. 1.6 in stage IV (p < 0.001), relative to ISUP4 ccRCC.CONCLUSION: CDC patients exhibited 40-90 % higher CSM than their ISUP4 ccRCC counterparts in the overall analysis, as well as in stage specific analyses. The CSM disadvantage applies despite higher rates of systemic therapy in CDC patients.
KW - Humans
KW - Carcinoma, Renal Cell/pathology
KW - Kidney Neoplasms/pathology
KW - Proportional Hazards Models
KW - Lymph Nodes/pathology
KW - Nephrectomy
U2 - 10.1016/j.canep.2022.102297
DO - 10.1016/j.canep.2022.102297
M3 - SCORING: Journal article
C2 - 36401949
VL - 82
SP - 102297
JO - CANCER EPIDEMIOL
JF - CANCER EPIDEMIOL
SN - 1877-7821
ER -