Association of Histologic Growth Patterns and Some Histopathologic Features in Clear Cell Renal Cell Carcinoma with Patient's Survival after Nephrectomy: A Cross-Sectional Study.

Background & objective: Clear cell renal cell carcinoma (CCRCC) is the most common type of renal cancer. Limited studies have been conducted about factors affecting the survival of patients with CCRCC. In this study, we aimed to evaluate the association between histologic growth patterns (HGPs) and some pathologic features and survival in CCRCC.

Methods: This cross-sectional study evaluated the association between HGPs and other pathologic features and the survival of 145 patients with CCRCC after nephrectomy in Emam-Reza Hospital (Mashhad, Iran) from 2012 to 2022. Two expert pathologists assessed HGPs and other pathologic features, like cytopathologic changes. All analyses were performed using IBM SPSS version 26 software. A P value less than 0.05 was considered statistically significant.

Results: In the current study, we assessed the association of the 6 most prevalent growth patterns with the patient's survival. Some clinicopathologic features like tumor stage and grade, tumor size, and necrosis are negatively linked with survival. Two important cytologic features, including sarcomatoid and rhabdoid, were also associated with survival time in patients with CCRCC (P values < 0.05). Regardless of the nuclear grade of the tumor, some patterns like solid sheet, papillary, and thick trabecular were associated with lower survival.

Conclusion: Some HGPs are significantly associated with the patient's survival in CCRCC. A greater variety of patterns within each specimen has been associated with a reduced survival rate. The impact of HGPs on patient survival may be as significant as the nuclear grade.