Sawczyn Guilherme, Brambilla Caio, Rodrigues Gilberto Jose, Pereira Maykon William Aparecido Pires, Cardili Leonardo, de Carvalho Paulo Afonso, Gallucci Fabio Pescarmona, Sarkis Álvaro Sadek, Nahas William Carlos, Cordeiro Mauricio Dener
Department of Urology, Cancer Institute of the State of São Paulo , São Paulo, Brazil.
Department of Pathology, Cancer Institute of the State of São Paulo , São Paulo, Brazil.
Indian J Urol. 2025 Jan-Mar;41(1):51-58. doi: 10.4103/iju.iju_256_24. Epub 2025 Jan 1.
This study aims to assess the impact of unclassified renal cell carcinoma (uRCC) on clinical, pathological, and oncological outcomes compared with clear cell renal cell carcinoma (ccRCC).
We analyzed the data of 48 uRCC and 688 ccRCC cases, collected from a histopathological database at a single center from July 2011 to August 2019. uRCC cases were confirmed according to the 2016 World Health Organization classification. Baseline characteristics, clinical findings, and oncological outcomes were compared between the groups.
Patients with uRCC exhibited the same clinical symptoms as ccRCC patients, a higher prevalence of lymphadenopathy (31.2% vs. 15.8%, < 0.01), and greater sarcomatoid/rhabdoid differentiation on histology (12.5% vs. 5%, = 0.03) compared to ccRCC patients. Although there was no difference regarding overall metastasis at initial diagnosis, distant lymphadenopathy (16.7% vs. 7.8%, = 0.04) and liver metastasis (8.9% vs. 2.8%, = 0.04) were more common in the uRCC group. The two groups had similar high-grade (HG) frequency on histology (62.5% for uRCC vs. 53.7% for ccRCC, = 0.23). The estimated recurrence-free survival at 48 months was 94.3% for uRCC, 92.5% for low-grade (LG) ccRCC ( = 0.91), and 66.5% for HG ccRCC ( < 0.01). The estimated overall survival at 48 months was 66.1% for uRCC, 87.4% for LG ccRCC ( = 0.75), and 63.4% for HG ccRCC ( < 0.01).
Our study demonstrates that uRCC has significantly higher rates of lymphadenopathy, sarcomatoid differentiation, and liver metastasis compared to ccRCC. Despite these differences, uRCC presents with similar clinical symptoms and histological grade as ccRCC. Furthermore, uRCC exhibits a recurrence rate comparable to LG ccRCC and an overall survival rate similar to HG ccRCC.
本研究旨在评估未分类肾细胞癌（uRCC）与透明细胞肾细胞癌（ccRCC）相比，对临床、病理和肿瘤学结局的影响。
我们分析了2011年7月至2019年8月从单一中心的组织病理学数据库收集的48例uRCC和688例ccRCC病例的数据。uRCC病例根据2016年世界卫生组织分类进行确诊。比较两组的基线特征、临床发现和肿瘤学结局。
与ccRCC患者相比，uRCC患者表现出与ccRCC患者相同的临床症状，淋巴结病患病率更高（31.2%对15.8%，<0.01），组织学上肉瘤样/横纹肌样分化更明显（12.5%对5%，=0.03）。尽管初诊时总体转移情况无差异，但远处淋巴结病（16.7%对7.8%，=0.04）和肝转移（8.9%对2.8%，=0.04）在uRCC组更常见。两组组织学上高级别（HG）频率相似（uRCC为62.5%，ccRCC为53.7%，=0.23）。uRCC在48个月时的无复发生存率估计为94.3%，低级别（LG）ccRCC为92.5%（=0.91），HG ccRCC为66.5%（<0.01）。uRCC在48个月时的总生存率估计为66.1%，LG ccRCC为87.4%（=0.75），HG ccRCC为63.4%（<0.01）。
我们的研究表明，与ccRCC相比，uRCC的淋巴结病、肉瘤样分化和肝转移率显著更高。尽管存在这些差异，但uRCC的临床症状和组织学分级与ccRCC相似。此外，uRCC的复发率与LG ccRCC相当，总生存率与HG ccRCC相似。
