Impact of histological subtype on outcomes of renal cell carcinoma patients

Abstract

Background: This study aims to tackle the impact of histological subtype on the presentation and treatment trends of renal cell carcinoma (RCC).Methods: RCC cases, diagnosed from 2001 to 2013, were assembled from the Surveillance, Epidemiology and End Results (SEER) database. The incidence of different RCC histological subtypes (clear cell, papillary, chromophobe and collecting duct) was assessed and Join-Point analysis was conducted. Relevant clinicopathological characteristics were assessed and correlated with subtypes through chi-square testing. Survival analysis was then evaluated using Kaplan–Meier analysis and multivariate analyses for factors affecting overall and cancer-specific survivals were assessed.Results: A total of 89,968 RCC patients were evaluated. The incidence of different RCC subtypes has increased during the study period. Chromophobe subtype seems to have the best overall and cancer-specific survivals, whilst collecting duct subtype has the worst outcomes (p < .0001 for all endpoints). Multivariate analysis for factors affecting overall survival among non-metastatic RCC patients showed that the following factors are associated with worse overall survival (collecting duct carcinoma histology, older age, T4 disease, N2 disease, no receipt of local treatment, black race, male gender and unmarried status) (p < .0001 for all parameters).Conclusion: This analysis suggests that the prognosis of RCC varies widely according to the histological subtype. Biology-oriented preclinical and clinical assessments of novel therapeutics are needed particularly for non-clear cell RCC.