Abstract
ObjectiveTo investigate the exact age‐adjusted incidence (AAI), clinical characteristics, and survival data of collecting duct carcinoma of the kidney (CDCK) recorded in the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute.MethodsPatients with CDCK confirmed by microscopic examination from 2004 to 2018 were selected from the SEER database. AAI rates were calculated using SEER*Stat software (version 8.3.9). The Kaplan‐Meier method was used to evaluate cancer-specific survival (CSS) rates according to tumor size, tumor stage, and treatment methods, and differences among these variables were assessed by the log‐rank test. Cox regression analysis was employed to identify variables independently related to CSS.ResultsA total of 286 patients with CDCK were identified from the database. The majority of the patients were white (69.2%), male (67.5%), and married (60.5%), and the median age was 59 years. Most patients with CDCK (74.4%) presented with stages III or IV disease. The diameter of most (59.4%) tumors was less than 7 cm, and the tumors were more commonly found on the left than on the right (55.2% vs. 44.8%). The incidence of CDCK decreased over time. The median CSS time was 17 months. In terms of the treatment modalities used, 83.9% of the patients underwent surgery; 32.9% underwent chemotherapy, and 13.6% underwent radiotherapy. The CSS rates at 1, 2, and 5 years were 57.3%, 43.2%, and 30.7%, respectively. In patients with stage IV CDCK treated with surgery alone, chemotherapy alone, and surgery plus chemotherapy, the median survival time was 5 months, 9 months, and 14 months, respectively (P =0.024). Multivariate Cox regression analysis showed surgery, chemotherapy, stage, regional lymph node metastasis, and distant metastasis were independent prognostic factors for patients with CDCK.ConclusionsCDCK is an uncommon malignant renal carcinoma, and its incidence is decreasing based on the analysis of current data. CDCK is a high stage, regional lymph-nodes positive, and metastatic disease. Compared with surgery alone or chemotherapy alone, patients with stage IV could gain survival benefit from surgery combined with chemotherapy.
Highlights
Collecting duct carcinoma of the kidney (CDCK), which is believed to arise from the epithelial layer of the collecting ducts of Bellini in the renal medullary, is an uncommon pathological subtype of renal carcinoma and accounts for 0%–3% of all renal malignancies [1,2,3]
In terms of chemotherapy stratified according to tumor stage, patients presenting with stage IV CDCK who underwent chemotherapy had higher survival rates than patients without chemotherapy (P =0.014; Figure 3C)
Patients presenting with stage IV CDCK who underwent surgery plus chemotherapy had higher survival rates than those who underwent surgery or chemotherapy alone (14 months, 5 months, and 9 months, respectively; P = 0.024; Figure 3D), while survival rates were similar between patients who underwent surgery or chemotherapy alone (P = 0.505)
Summary
Collecting duct carcinoma of the kidney (CDCK), which is believed to arise from the epithelial layer of the collecting ducts of Bellini in the renal medullary, is an uncommon pathological subtype of renal carcinoma and accounts for 0%–3% of all renal malignancies [1,2,3]. Wright JL et al [6] compared cases of CDCK and clear cell renal cell carcinomas (CCRCC) recorded in the SEER database from 2001 to 2005 and found that patients with CDCK had a higher stage and poorer prognosis compared with CCRCC. This result is consistent with the largest report on CDCK by Sui W et al [7]. Abern MR et al [8] compared the cancer-specific survival (CSS) rates of medullary renal cell carcinoma and CDCK from 1995 to 2007 recorded in the SEER database, and found that the prognosis of both diseases is generally poor; locally high stage or metastatic disease and not receiving surgery were considered predictors of mortality in the CDCK model
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