Life Expectancy of Renal Cell Carcinoma with Variant Histology.

IF 5.6 2区医学 Q1 UROLOGY & NEPHROLOGY

European urology focus Pub Date : 2025-08-20 DOI:10.1016/j.euf.2025.05.023

Quynh Chi Le, Andrea Marmiroli, Mattia Longoni, Fabian Falkenbach, Calogero Catanzaro, Michele Nicolazzini, Federico Polverino, Jordan A Goyal, Fred Saad, Riccardo Schiavina, Luca Fabio Carmignani, Alberto Briganti, Nicola Longo, Markus Graefen, Carlotta Palumbo, Mike Wenzel, Clara Humke, Marina Kosiba, Felix K-H Chun, Pierre I Karakiewicz

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Abstract

Background and objective: The effect of variant histology in renal cell carcinoma (vhRCC) on survival relative to age- and sex-matched population-based controls is unknown. This study aims to analyze the life expectancy of vhRCC patients.

Methods: In the Surveillance, Epidemiology and End Results (SEER) database (2004-2016), we identified 2928 patients with vhRCC, including mesenchymal, collecting duct, medullary, mucinous, and neuroendocrine RCC, as well as RCC of sarcomatoid and rhabdoid differentiation. Kaplan-Meier plots addressed overall survival relative to simulated life expectancy in population-based controls (Monte Carlo simulation), were derived from the Social Security Administration life tables.

Key findings and limitations: Of the 2928 vhRCC patients, 1905 (65%) harbored sarcomatoid, 404 (14%) mesenchymal, 318 (11%) collecting duct, 94 (3%) rhabdoid, 80 (3%) medullary, 68 (2%) mucinous, and 59 (2%) neuroendocrine RCC. Most vhRCC subtypes exhibit regional or metastatic stage at diagnosis, except for mucinous RCC. When diagnosed in metastatic stage, all vhRCC subtypes exhibited a decrease in survival rate ranging from -75% to -98% between controls and cases, except for mucinous and neuroendocrine RCC, with the least decrease in survival rate of -62% and -59%, respectively. In regional stage, all vhRCC subtypes exhibited a decrease in survival rate ranging from -68% to -41% between controls and cases, except for neuroendocrine RCC, with the least decrease in survival rate of -27%. Finally, in localized stage, all vhRCC subtypes exhibited a decrease in survival rate ranging from -56% to -22% between controls and cases, except for rhabdoid and mucinous RCC, with the least decrease in survival rate of -11% and -6%, respectively.

Conclusions and clinical implications: Most vhRCC subtypes reduce survival drastically relative to life expectancy of population-based controls, except for localized rhabdoid and mucinous RCC. Especially, medullary RCC leads to distinct reductions in life expectancy, irrespective of the stage at presentation.

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不同组织学肾细胞癌的预期寿命。

背景和目的：相对于年龄和性别匹配的人群对照，肾细胞癌（vhRCC）组织学变异对生存率的影响尚不清楚。本研究旨在分析vhRCC患者的预期寿命。方法：在监测、流行病学和最终结果（SEER）数据库（2004-2016）中，我们确定了2928例vhRCC患者，包括间质、集管、髓质、粘液和神经内分泌的RCC，以及肉瘤样和横纹肌样分化的RCC。Kaplan-Meier图描述了总体生存率相对于基于人群的控制（蒙特卡洛模拟）的模拟预期寿命，该图来源于社会保障管理局的生命表。主要发现和局限性：2928例vhRCC患者中，肉瘤样1905例（65%），间质404例（14%），集管318例（11%），横纹肌样94例（3%），髓质80例（3%），粘液样68例（2%），神经内分泌RCC 59例（2%）。大多数vhRCC亚型在诊断时表现为区域或转移期，粘液性RCC除外。当诊断为转移期时，所有vhRCC亚型在对照组和病例之间的生存率均下降了-75%至-98%，除了黏液和神经内分泌的RCC，其生存率下降最少，分别为-62%和-59%。在区域分期，所有vhRCC亚型在对照组和病例之间的生存率下降幅度在-68%至-41%之间，除神经内分泌型RCC外，生存率下降幅度最小，为-27%。最后，在局部分期，所有vhRCC亚型的存活率在对照组和病例之间下降了-56%至-22%，除了横纹肌和粘液性RCC，存活率下降最少，分别为-11%和-6%。结论和临床意义：大多数vhRCC亚型相对于以人群为基础的对照组的预期寿命显著降低生存率，除了局限性横纹肌样和粘液性RCC。特别是髓性肾细胞癌，无论发病阶段如何，都会导致预期寿命明显缩短。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European urology focus Medicine-Urology

CiteScore

10.40

自引率

3.70%

发文量

274

审稿时长

23 days

期刊介绍： European Urology Focus is a new sister journal to European Urology and an official publication of the European Association of Urology (EAU). EU Focus will publish original articles, opinion piece editorials and topical reviews on a wide range of urological issues such as oncology, functional urology, reconstructive urology, laparoscopy, robotic surgery, endourology, female urology, andrology, paediatric urology and sexual medicine. The editorial team welcome basic and translational research articles in the field of urological diseases. Authors may be solicited by the Editor directly. All submitted manuscripts will be peer-reviewed by a panel of experts before being considered for publication.