633 CLINICAL CHARACTERISTICS OF ONCOCYTIC PAPILLARY RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced II1 Apr 2010633 CLINICAL CHARACTERISTICS OF ONCOCYTIC PAPILLARY RENAL CELL CARCINOMA Tomas Ürge, Hora Milan, Ondrej Hes, Jiri Ferda, Zdenek Chudacek, Viktor Eret, Jiri Klecka, Michal Michal, and Petr Stransky Tomas ÜrgeTomas Ürge More articles by this author , Hora MilanHora Milan More articles by this author , Ondrej HesOndrej Hes More articles by this author , Jiri FerdaJiri Ferda More articles by this author , Zdenek ChudacekZdenek Chudacek More articles by this author , Viktor EretViktor Eret More articles by this author , Jiri KleckaJiri Klecka More articles by this author , Michal MichalMichal Michal More articles by this author , and Petr StranskyPetr Stransky More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.969AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Two variants (type 1, 2 by Delahunt) of papillary renal cell carcinoma (PRCC) are traditionally differentiated. Type 1 has a more favourable survival rate than type 2 as asserted by some authors. A new histopathologic variant of PRCC was described in 2005 and named oncocytic PRCC (O-PRCC). Articles about O-PRCC have to date been published in pathological literature. We have compared clinical data of O-PRCC and other types of PRCC. METHODS From January 1992 to October 2009, 1398 patients with 1436 renal tumours were surgically treated in our institution. We have valorised some clinical data of different types of PRCCs (mainly tumour size, necrotic changes, presence of pseudocapsula and real extrarenal growth defined, when at least 2/3 of the mass is outside the kidney's border on a CT). RESULTS PRCCs were described in 109 (7.6%) cases. O-PRCC was in 12 (11%), PRCC type 1 in 86 (78.9%), PRCC type 2 in 8 (7.3%) and others in 3 (2.8%) cases. O-PRCCs was more frequent in men (66.7%). The patient's mean age with O-PRCC was 67.5 ± 10.9, in other PRCC 65.8 ± 7.5 years, the mean tumour size was 35 ± 12, in others 43 ± 17 mm. Necrotic changes were described on CTs only in PRCC type 1 and 2 (31.6%), more common were sight in gross pathology (35.8% vs 33.3% in O-PRCC). We did not find statistical significant divergence in frequency of necrotic changes in PRCC's variants (Kruskal – Wallis test p = 0.3679). Real extrarenal growth was found only in two O-PRCCs (16.7%) vs. 40.7% in PRCC type 1, but we did not see any pseudocapsula in O-PRCC. O-PRCC had more frequent invasive type of growth than PRCC type 1 (category pT3a 16.7% vs. 11.8%; category pT3b 25% vs. 14.2%) and nephrectomy was more often provided (7/12, 58.3%). PRCC type 2 category pT3b we had in 25% cases and nephrectomy we provided in 75% cases. Nobody with O-PRCC had recurrence. Fifteen patients with PRCC type 1 (17.4%) died for metastases. Three patients of those had the sarcomatoid variant PRCC type 1 (category pT3b, pT3b pN1 and pT2). Patients died 3.7, 4.7 and 6.7 months later for metastases. CONCLUSIONS We are able to differentiate three variants of PRCC by morphology and by using immunohistochemical methods: type I, II and oncocytic. In comparison of O-PRCC with PRCC type I and II, none of the O-PRCC had pseudocapsula and none had massive necroses, we supposed the probability of rupture to be very low. Extrarenal growth is relatively rare and nephrectomy is often necessary. The malignant potential is low. The work was supported by Czech government research project MSM 0021620819 Plzen, Czech Republic© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e248-e249 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.The work was supported by Czech government research projectMSM 0021620819MetricsAuthor Information Tomas Ürge More articles by this author Hora Milan More articles by this author Ondrej Hes More articles by this author Jiri Ferda More articles by this author Zdenek Chudacek More articles by this author Viktor Eret More articles by this author Jiri Klecka More articles by this author Michal Michal More articles by this author Petr Stransky More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...