Bigot Pierre, Bernhard Jean-Christophe, Gill Inderbir S, Vuong Nam Son, Verhoest Grégory, Flamand Vincent, Reix Boris, Suer Evren, Gökce Ilker, Beauval Jean Baptiste, Nouhaud François Xavier, Eto Masatoshi, Baco Eduard, Matsugasumi Toru, Chowaniec Yvonne, Rigaud Jérôme, Lenormand Claire, Pfister Christian, Hetet Jean François, Ploussard Guillaume, Roupret Morgan, Léon Priscilla, Bakri Adnan El, Larré Stéphane, Tillou Xavier, Doerfler Arnaud, Descazeaud Aurélien, Koutlidis Nicolas, Schneider Alexandre, Sebe Philippe, Ingels Alexandre, Azzouzi Abdel Rahmène, Soulié Michel, Méjean Arnaud, Bensalah Karim, Patard Jean-Jacques
Cancerology Committee of the French Association of Urology (CCAFU), Paris, France.
French Network for Research on Kidney Cancer (UroCCR), Bordeaux, France.
World J Urol. 2016 Mar;34(3):347-52. doi: 10.1007/s00345-015-1634-0. Epub 2015 Jul 7.
To evaluate the oncological outcomes of papillary renal cell carcinoma (pRCC) following nephron sparing surgery (NSS) and to determine whether the subclassification type of pRCC could be a prognostic factor for recurrence, progression, and specific death.
An international multicentre retrospective study involving 19 institutions and the French network for research on kidney cancer was conducted after IRB approval. We analyzed data of all patients with pRCC who were treated by NSS between 2004 and 2014.
We included 486 patients. Tumors were type 1 pRCC in 369 (76 %) cases and type 2 pRCC in 117 (24 %) cases. After a mean follow-up of 35 (1-120) months, 8 (1.6 %) patients experienced a local recurrence, 12 (1.5 %) had a metastatic progression, 24 (4.9 %) died, and 7 (1.4 %) died from cancer. Patients with type I pRCC had more grade II (66.3 vs. 46.1 %; p < 0.001) and less grade III (20 vs. 41 %; p < 0.001) tumors. Three-year estimated cancer-free survival (CFS) rate for type 1 pRCC was 96.5 % and for type 2 pRCC was 95.1 % (p = 0.894), respectively. Three-year estimated cancer-specific survival rate for type 1 pRCC was 98.4 % and for type 2 pRCC was 97.3 % (p = 0.947), respectively. Tumor stage superior to pT1 was the only prognostic factor for CFS (HR 3.5; p = 0.03).
Histological subtyping of pRCC has no impact on oncologic outcomes after nephron sparing surgery. In this selected population of pRCC tumors, we found that tumor stage is the only prognostic factor for cancer-free survival.
评估保留肾单位手术（NSS）后乳头状肾细胞癌（pRCC）的肿瘤学结局，并确定pRCC的亚分类类型是否可能成为复发、进展和特异性死亡的预后因素。
在获得机构审查委员会（IRB）批准后，开展了一项涉及19个机构以及法国肾癌研究网络的国际多中心回顾性研究。我们分析了2004年至2014年间接受NSS治疗的所有pRCC患者的数据。
我们纳入了486例患者。肿瘤为1型pRCC的有369例（76%），2型pRCC的有117例（24%）。平均随访35（1 - 120）个月后，8例（1.6%）患者出现局部复发，12例（1.5%）发生远处转移进展，24例（4.9%）死亡，7例（1.4%）死于癌症。1型pRCC患者的II级肿瘤更多（66.3%对46.1%；p < 0.001），III级肿瘤更少（20%对41%；p < 0.001）。1型pRCC的三年无癌生存率（CFS）估计为96.5%，2型pRCC为95.1%（p = 0.894）。1型pRCC的三年癌症特异性生存率为98.4%，2型pRCC为97.3%（p = 0.947）。高于pT1的肿瘤分期是CFS的唯一预后因素（HR 3.5；p = 0.03）。
pRCC的组织学亚型对保留肾单位手术后的肿瘤学结局无影响。在这个选定的pRCC肿瘤人群中，我们发现肿瘤分期是无癌生存的唯一预后因素。
