A critical assessment of the prognostic value of clear cell, papillary and chromophobe histological subtypes in renal cell carcinoma: a population-based study
Version of Record online: 8 DEC 2008
© 2008 THE AUTHORS. JOURNAL COMPILATION © 2008 BJU INTERNATIONAL
Volume 103, Issue 11, pages 1496–1500, June 2009
How to Cite
Capitanio, U., Cloutier, V., Zini, L., Isbarn, H., Jeldres, C., Shariat, S. F., Perrotte, P., Antebi, E., Patard, J.-J., Montorsi, F. and Karakiewicz, P. I. (2009), A critical assessment of the prognostic value of clear cell, papillary and chromophobe histological subtypes in renal cell carcinoma: a population-based study. BJU International, 103: 1496–1500. doi: 10.1111/j.1464-410X.2008.08259.x
- Issue online: 11 MAY 2009
- Version of Record online: 8 DEC 2008
- Accepted for publication 25 September 2008
- renal cell carcinoma;
- histological subtypes;
- clear cell;
- cause-specific mortality
To assess the magnitude of the effect of histological subtype (HS, the three most common being clear cell, papillary and chromophobe) on cause-specific mortality (CSM) from renal cell carcinoma (RCC).
PATIENTS AND METHODS
Univariable and multivariable Cox regression models included data from 11 618 patients treated with nephrectomy between 1988 and 2004 in nine Surveillance Epidemiology and End Results registries. We tested whether HS represents an independent predictor of CSM, and whether HS adds to the ability of other variables to predict CSM. The covariates comprised age, year of surgery, T stage, nodal status, M stage and Fuhrman grade.
In a multivariable model predicting CSM, HS was an independent predictor (P = 0.03), but failed to improve the accuracy of the model (+0.1% gain when HS was included in the model).
Although we confirmed that HS is an independent predictor for CSM, there was no gain in accuracy when HS was added to standard predictors of CSM. From a practical perspective, this implies that patients with clear cell, papillary and chromophobe HS share similar natural histories after nephrectomy, provided that other cancer characteristics are accounted for. From a statistical perspective, in multivariable models of CSM, the clear cell, papillary and chromophobe HS might be included as a single entity.