Adult urologySurvival Analysis of 130 Patients with Papillary Renal Cell Carcinoma: Prognostic Utility of Type 1 and Type 2 Subclassification
Section snippets
Patients
From January 1995 to December 2004, 133 (9.8%) of 1358 patients undergoing surgery for RCC were diagnosed with PRCC. At surgery, 3 of these 133 patients had coexisting clear cell RCC and PRCC on the specimen and were excluded from the study. The remaining 130 patients included 110 men and 20 women (mean age 60.6 ± 15.3 years, range 17.2 to 85.2). Data were obtained from the patients’ medical records. The presenting symptoms, preoperative investigation findings, pathologic features, treatment,
Results
Patient, treatment, and tumor characteristics according to pathologic tumor subtype are given in Table 1.
Comment
PRCC is a well-recognized distinct tumor type among renal tumors exhibiting a large range of morphologic variants.6, 12 We reviewed 130 cases of PRCC and stratified them as type 1 or type 2 according the histologic features and found a prognostic significance with this subdivision.
PRCCs are typically characterized by a predominant papillary pattern (50% or more of the tumor),3, 4, 12 a cytokeratin 7-positive immunophenotype,6 and recurrent cytogenetic alterations (trisomy or tetrasomy 7/17,
Conclusions
The histologic classification of renal tumors is evolving with cytogenetic and molecular data, and it appears that the papillary group is more heterogeneous than previously thought. As our results have demonstrated, the subclassification of PRCC according to Delahunt and Eble6 is of clinical relevance. The identification of type 2 PRCC may have important implications in the development of adjuvant treatment for locally advanced or poor prognosis tumors.
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