Clear cell papillary renal cell carcinoma: Characteristics and survival outcomes from a large single institutional series

•Clear cell papillary renal cell carcinoma is common among African American patients and patients with ESRD undergoing kidney cancer surgery.•Over one-fourth of the patient cohort had multifocal disease.•Clear cell papillary renal cell carcinoma typically presents at a low stage and grade. In this s...

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Veröffentlicht in:Urologic oncology 2021-06, Vol.39 (6), p.370.e21-370.e25
Hauptverfasser: Steward, James E., Kern, Sean Q., Cheng, Liang, Boris, Ronald S., Tong, Yan, Bahler, Clint D., Masterson, Timothy A., Cary, K. Clint, Kaimakliotis, Hristos, Gardner, Thomas, Sundaram, Chandru P.
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Sprache:eng
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Zusammenfassung:•Clear cell papillary renal cell carcinoma is common among African American patients and patients with ESRD undergoing kidney cancer surgery.•Over one-fourth of the patient cohort had multifocal disease.•Clear cell papillary renal cell carcinoma typically presents at a low stage and grade. In this study, 91.1% of cases were pT1 and 96.7% were grade 1 or 2.•Clear cell papillary renal cell carcinoma has favorable survival outcomes. In our cohort, there were no cancer specific deaths, overall survival at median follow up was 92%, and there was only one local recurrence. To investigate the clinical characteristics and survival outcomes of a large clear cell papillary renal cell carcinoma cohort. A retrospective review of patients with clear cell papillary renal cell carcinoma at a single academic center was performed after Institutional Review Board approval. Patients underwent either partial or radical nephrectomy from September 2009 to July 2019. Demographic and clinical characteristics, recurrence, and cancer specific and overall survival were reported. A total of 90 patients were included in the study. Median follow up was 26.5 months. Median age was 61 (range 27 to 87). 47.8% of patients were African American. 26.7% of patients had end stage renal disease. 37.8% had multifocal renal tumors. 48.9% underwent partial nephrectomy, while the remainder underwent radical nephrectomy. 43.3% underwent an open surgical approach, 40.0% a robotic approach, and 16.7% a laparoscopic approach. Pathologic stage included T1a (90.0%), T1b (1.1%), and T2b (8.9%). Fuhrman grades 1-3 were present in 18.9%, 77.8%, and 3.3% of patients, respectively. There were no cancer specific deaths. There was one local recurrence and no metastases. The overall survival at a median follow up of 26.5 months was 92.1% (95% confidence interval 83.1%–96.4%). Clear cell papillary renal cell carcinoma typically presents at a low stage and grade and has favorable survival outcomes. A nephron-sparing approach to treatment should be considered when feasible due to the tumor's indolent nature and propensity towards multifocality.
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2021.02.003