肉瘤样成分的百分比丰度在4级非转移性透明细胞肾细胞癌中具有预后作用。

The percentage abundance of sarcomatoid component has a prognostic role in grade 4 non-metastatic clear cell-renal carcinoma.

作者信息

Lucarelli Giuseppe, Lasorsa Francesco, Rutigliano Monica, Milella Martina, Spilotros Marco, d'Amati Antonio, Ingravallo Giuseppe, Crocetto Felice, Pandolfo Savio Domenico, Fabiano Marco, Ferro Matteo, Autorino Riccardo, Battaglia Michele, Ditonno Pasquale

机构信息

Urology, Andrology and Kidney Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy.

Pathology Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy.

出版信息

World J Urol. 2025 Apr 23;43(1):243. doi: 10.1007/s00345-025-05630-4.

DOI:10.1007/s00345-025-05630-4

PMID:40266374

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12018525/

Abstract

PURPOSE

Sarcomatoid dedifferentiation represents one of the most aggressive features of clear cell renal cell carcinoma (ccRCC). In this study we evaluated whether grade 4-ccRCC subclassification based on the intratumoral abundance of sarcomatoid features could have a prognostic impact.

METHODS

A cohort of 212 patients with localized or locally advanced sarcomatoid ccRCC was identified. This population was stratified according to abundance of sarcomatoid features in low-sarcomatoid (LS = < 20% sarcomatoid component; n = 117) and high-sarcomatoid (HS = ≥ 20% sarcomatoid component; n = 95). Estimates of cancer-specific survival (CSS) and recurrence-free survival (RFS) were calculated according to the Kaplan-Meier method and compared with the log-rank test. Multivariable analysis was performed using the Cox proportional hazards regression model to identify the most significant variables for predicting CSS and RFS.

RESULTS

Kaplan-Meier survival curves stratified by abundance of sarcomatoid component, showed that CSS and RFS were significantly decreased in patients with sarcomatoid component ≥ 20% (both P < 0.0001). At multivariable analysis by Cox regression modeling, the abundance of sarcomatoid component was an independent adverse prognostic factor for CSS (P < 0.0001) and RFS (P < 0.0001).

CONCLUSION

ccRCC Subclassification based on the abundance of intratumoral sarcomatoid component has a clinical significance. Our study showed that ccRCC subclassification into HS versus LS groups had a prognostic impact in terms of CSS and RFS in non-metastatic ccRCC.

摘要

目的

肉瘤样去分化是透明细胞肾细胞癌（ccRCC）最具侵袭性的特征之一。在本研究中，我们评估了基于肿瘤内肉瘤样特征丰度的4级ccRCC亚分类是否具有预后影响。

方法

确定了一组212例局限性或局部晚期肉瘤样ccRCC患者。根据肉瘤样特征的丰度将该人群分为低肉瘤样组（LS =肉瘤样成分<20%；n = 117）和高肉瘤样组（HS =肉瘤样成分≥20%；n = 95）。根据Kaplan-Meier方法计算癌症特异性生存率（CSS）和无复发生存率（RFS），并通过对数秩检验进行比较。使用Cox比例风险回归模型进行多变量分析，以确定预测CSS和RFS的最显著变量。