Management, outcomes and predictors of recurrence in chromophobe renal cell carcinoma: Results from the Canadian Kidney Cancer information system (CKCis).
Journal Articles
Overview
Research
Identity
Additional Document Info
View All
Overview
abstract
389 Background: Chromophobe RCC (chRCC) make up 5% of all RCC however data regarding baseline demographics, management, outcomes, and predictors of recurrence and survival is lacking. Methods: The Canadian Kidney Cancer Information System (CKCis) is a multi-institutional prospective cohort. Patients (pts) with clinically localized chRCC between Jan 2011-Aug 2023 were included. Descriptive statistics were used, time to recurrence and death were estimated using Kaplan-Meier estimates and associations were determined using Cox proportional hazards models. Results: chRCC made up 5.3% of all RCC pts in CKCis and only 2.4% presented with metastatic disease. This study cohort includes 797 pts who presented with localized disease. Median follow up 4.1 yrs, mean age 58.4 yrs and male in 58.5%. Management included: surgery 90.2%, surveillance 5.5%, or other local modalities 3.3%. Recurrence occurred in 59 pts (7.4%): 50 (85%) with metastases, 7 (12%) with local recurrence, and 2 (3.4%) with contralateral tumors. Median time to recurrence was 2 yrs. Management of recurrences included: systemic therapy in 46%, radiation in 29%, metastasectomy in 25%, surveillance in 8%. 5 and 10 year overall survival was 95% and 83% in all pts, 97% and 90% if no recurrence and 75% and 44% if recurrence. In the 90.2% (718 pts) treated with curative surgery, predictors of recurrence on multivariate analysis include: higher T stage, necrosis, and sarcomatoid features. Predictors of worse survival include: sarcomatoid features, larger tumor size, higher T stage, and higher number of comorbidities. Conclusions: In this large Canadian cohort, patients with chRCC usually present with localized disease and have relatively favorable oncologic outcomes, even when they recur. Larger tumors with sarcomatoid features have a worse survival and more intensive follow up may be beneficial. The favorable 5 and 10 year outcomes in chRCC are a reminder that studies must be conducted and reported for individual histologies and not as a large cohort of non clear cell RCC. [Table: see text]
