Relevance of the clinical–pathological predictive factors in force in chromophobe renal cell cancer

Abstract

IntroductionThe identification of new subtypes of renal cell carcinoma (RCC) has made it necessary to re-evaluate the current clinical and pathological predictive factors (stage, Fuhrman nuclear grade, necrosis, lymphovascular invasion [LVI] and sarcomatoid component) in these new subtypes. The chromophobe renal cell carcinoma (CRCC) is considered a less aggressive subtype of RCC. The purpose of this article is to evaluate the usefulness of current clinicopathologic predictors of RCC in our series of CRCC. Material and methodsWe retrospectively reviewed the clinicopathologic features of 63 patients with CRCC treated with radical nephrectomy. The parameters analyzed were tumor extension with the TNM, grade according to Fuhrman classification, LVI, tumor necrosis, tumor thrombus, surgical margin status, and involvement of the collecting system. The results (disease recurrence) were evaluated by Cox regression model with univariate and multivariate analysis. ResultsWith a median follow up of 60.2 months (0.37–160.2), 8 (11%) patients had recurrence, with median time to recurrence of 31.7 months (5.37–124.33). In the univariate analysis, TNM extension (p=0.0001), Fuhrman grade III or IV (p=0.031), LVI (p=0.0001) and the presence of positive surgical margins (p=0.0001) were statistically significant variables for recurrence. In the multivariate analysis, only tumor stage was confirmed as an independent predictor of recurrence, pT1 versus pT2 (p=0.02; OR 0.27; 95% CI 0.03–0.258) and pT2 versus higher stage (p=0.037; OR 0.173; 95% CI 0.033–0.896). ConclusionsThe tumor stage predicts aggressiveness in the CCRC. The classification of Fuhrman nuclear grade is not useful for this histological subtype.