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Pattern, timing and predictors of recurrence after surgical resection of chromophobe renal cell carcinoma.

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Peer-reviewed

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Article

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Authors

Vanaclocha Saiz, Leyre  ORCID logo  https://orcid.org/0000-0002-7215-2105
Marchetti, Marta 
Tran-Dang, My-Anh 

Abstract

PURPOSE: Currently there are no specific guidelines for the post-operative follow-up of chromophobe renal cell carcinoma (chRCC). We aimed to evaluate the pattern, location and timing of recurrence after surgery for non-metastatic chRCC and establish predictors of recurrence and cancer-specific death. METHODS: Retrospective analysis of consecutive surgically treated non-metastatic chRCC cases from the Royal Free London NHS Foundation Trust (UK, 2015-2019) and the international collaborative database RECUR (15 institutes, 2006-2011). Kaplan-Meier curves were plotted. The association between variables of interest and outcomes were analysed using univariate and multivariate Cox proportional hazards regression models with shared frailty for data source. RESULTS: 295 patients were identified. Median follow-up was 58 months. The five and ten-year recurrence-free survival rates were 94.3% and 89.2%. Seventeen patients (5.7%) developed recurrent disease, 13 (76.5%) with distant metastases. 54% of metastatic disease diagnoses involved a single organ, most commonly the bone. Early recurrence (< 24 months) was observed in 8 cases, all staged ≥ pT2b. 30 deaths occurred, of which 11 were attributed to chRCC. Sarcomatoid differentiation was rare (n = 4) but associated with recurrence and cancer-specific death on univariate analysis. On multivariate analysis, UICC/AJCC T-stage ≥ pT2b, presence of coagulative necrosis, and positive surgical margins were predictors of recurrence and cancer-specific death. CONCLUSION: Recurrence and death after surgically resected chRCC are rare. For completely excised lesions ≤ pT2a without coagulative necrosis or sarcomatoid features, prognosis is excellent. These patients should be reassured and follow-up intensity curtailed.

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Keywords

Chromophobe renal cell carcinoma, Follow-up, Nephrectomy, Renal cell carcinoma, Survival, Adult, Aged, Aged, 80 and over, Bone Neoplasms, Carcinoma, Renal Cell, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Kidney Neoplasms, Male, Margins of Excision, Middle Aged, Multivariate Analysis, Necrosis, Neoplasm Recurrence, Local, Neoplasm Staging, Proportional Hazards Models, Risk Factors, Young Adult

Journal Title

World J Urol

Conference Name

Journal ISSN

0724-4983
1433-8726

Volume Title

39

Publisher

Springer Science and Business Media LLC

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All rights reserved