Analysing pathologic characteristics of early onset renal cell carcinoma in Asian population on the basis of SEER and Renji database

Abstract

Objective To identify clinicopathologic features of early onset RCC in Asian population. Methods Surveillance, Epidemiology, End Results Registry (SEER) database were queried for cases diagnosed as RCC in Asia or pacific islander between 2010 and 2015. Patients diagnosed with RCC in Renji hospital during 2014—2018 were reviewed. All Patients was divided into two group, including early onset group (≤46 years) and control group (>46 years). There were 3 023 patients with average age of 61 years old, ranging from 10-93 years old in SEER cohort and 2 702 patients with average age of 57 years old, ranging from 15-89 years old in Renji cohort. Early onset group took up 13.4%(406/3 023) in SEER cohort and 20.2%(546/2 702) in Renji cohort. Clinicopathologic characteristics were compared between groups in both cohorts. Results The histologic spectrum of early onset group was significantly different from control group comprising fewer clear cell renal cell carcinoma(76.8% vs. 84.8% in SEER cohort; 84.3% vs. 88.5% in Renji cohort), more chromophobe renal cell carcinoma(12.1% vs. 6.2% in SEER cohort; 11.2% vs. 4.8% in Renji cohort)(P<0.01 in both cohorts). 21 cases of Xp 11 translocation RCCs were identified in Renji cohort taking up 3.8%(21/546) of early onset group which was higher than that in control group(0.3%, 7/2 156), Von Hippel-Lindau syndromes took up 2.0%(11/546) of early onset group larger than control group (0.3%, 7/2 156). In addition, early onset RCC was more likely to be classified into lower pathological T stage(85.5% vs. 78.1% P=0.037 in SEER cohort; 96.1% vs. 91.2% P<0.01 in Renji cohort)containing more low-grade tumors (58.1% vs.53.4%, P=0.043 in SEER cohort; 85.2% vs.79.4%, P<0.01 in Renji cohort). The overall follow-up rate of SEER cohort was 96.0%(2 901/3 023), follow-up time ranges from 1 to 71 months with a median of 26 months. The 1-year , 3-year and 5-year overall survival rate were 94.0%、92.1%、92.1% in early onset group and 89.7%、81.1%、74.2% in control group, the differences were significant in statistics(P<0.01). Conclusions Asians who developed early onset RCC present with more ChRCC and fewer ccRCC compared to the older patients. Xp 11 translocation RCCs and VHL disease frequently occurred in younger group rather than the old counterparts. Younger patients diagnosed with RCC usually manifest lower T stage and tumor grade with a favorable prognosis. Key words: Carcinoma, renal cell; Histology; Asian continental ancestry group; Early onset renal cell carcinoma