Cancer specific mortality in patients with collecting duct vs. clear cell renal carcinoma |
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| Institution: | 1. Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy;2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada;3. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy;4. Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy;5. Department of Urology, IRCCS Policlinico San Martino, Genova, Italy;6. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany;7. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany;8. Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy;9. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany;10. Department of Urology, Koc University Hospital, Istanbul, Turkey;11. Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada;12. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria;13. Departments of Urology, Weill Cornell Medical College, New York, NY, USA;14. Department of Urology, University of Texas Southwestern, Dallas, TX, USA;15. Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan;1. Research Unit for General Practice, Aarhus, Bartholins Alle 2, 8000 Aarhus C, Denmark;2. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus C, Denmark;1. Max Planck Institute for Demographic Research, Rostock, Germany;2. School of Public Health, Chongqing Medical University, Chongqing, China;3. Department of Medical Sciences, University of Turin, Turin, Italy;4. Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland;1. Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Damascus University, Damascus, Syria;2. Faculty of Medicine, Albaath University, Homs, Syria;3. Faculty of Medicine, Damascus University, Damascus, Syria;4. Department of Oncology, Faculty of Medicine, Damascus University, Damascus, Syria;1. Hungarian National Cancer Registry and National Tumorbiology Laboratory, National Institute of Oncology, Budapest, Hungary;2. Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France;3. Department of Molecular Immunology and Toxicology and National Tumorbiology Laboratory, National Institute of Oncology, Budapest, Hungary;1. Univ. Bordeaux, Gironde General Cancer Registry, 33000 Bordeaux, France;2. Inserm, Bordeaux Population Health, Research Center U1219, Team EPICENE, 33000 Bordeaux, France;3. Centre Régional de Coordination du Dépistage des Cancers (CRCDC), Nouvelle Aquitaine, France;4. Loire-Atlantique/Vendée Cancer Registry, Nantes, France;5. CERPOP, Université de Toulouse, Toulouse, France;6. FRANCIM Network of French Cancer Registries, France;7. Breast and Gynaecologic Cancer Registry of Côte d’Or, Georges Francois Leclerc Comprehensive Cancer Centre, INSERM U1231, 1 rue Professeur Marion, Dijon, France;8. Epidemiology and Quality of Life Research Unit, INSERM U1231, Dijon, France;9. Institut Bergonie, Inserm CIC 1401, Clinical and Epidemiological Research Unit, 351 cours de la Libération, 33405 Talence cedex, France;1. Hereditary Cancer Program, Catalan Institute of Oncology-IDIBELL, ONCOBELL, Hospitalet de Llobregat, 08908 Barcelona, Spain;2. Biomedical Research Centre Network for Oncology (CIBERONC), Instituto Salud Carlos III, 28029 Madrid, Spain;3. Hereditary Cancer Program, Catalan Institute of Oncology, Badalona 08916, Barcelona, Spain;4. Department of Pathology, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain;5. Department of Gastroenterology, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain;6. Department of General Surgery, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain;7. Colorectal Cancer Multidisciplinary Board, Catalan Institute of Oncology, Hospitalet de Llobregat, 08908 Barcelona, Spain;8. Colorectal Cancer Multidisciplinary Board, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain;9. Department of Medical Oncology, Catalan Institute of Oncology, Hospitalet de Llobregat, 08908 Barcelona, Spain;10. Bellvitge Health Sciences Campus, University of Barcelona, Hospitalet de Llobregat, 08908 Barcelona, Spain;11. Department of Radiation Oncology, Catalan Institute of Oncology, Hospitalet de Llobregat, 08908 Barcelona, Spain;12. Hereditary Cancer Program, Catalan Institute of Oncology-IDIBGI, OncoGir-Pro, 17007 Girona, Spain |
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| Abstract: | BackgroundCollecting duct carcinoma (CDC) is biologically more aggressive than clear cell renal cell carcinoma (ccRCC). We tested for differences in cancer specific mortality (CSM) rates according to CDC vs. ISUP (International Society of Urological Pathology) 4 ccRCC histological subtype. We hypothesized that the survival disadvantage still applies, even after most detailed adjustments.MethodsWithin Surveillance, Epidemiology, and End Results database (2004–2018), we identified 380 CDC vs. 6273 ISUP 4 ccRCC patients of all stages. Propensity score matching (age, sex, race/ethnicity, T, N, and M stages, nephrectomy, and systemic therapy status), Kaplan-Meier plots and multivariable Cox regression models were used.ResultsAll 380 CDC were matched (1:2) with 760 ISUP4 ccRCC patients. Prior to matching CDC patients exhibited higher rates of lymph node invasion (37.6 % vs. 14.7 %, p < 0.001), and of distant metastases (40.8 % vs. 30.4 %, p < 0.001). Systemic therapy rates were higher in CDC (29.5 % vs. 20.5 %, p < 0.001). However, nephrectomy rates were higher in ISUP4 ccRCC patients (97.5 % vs. 84.7 %, p < 0.001). After matching, in multivariable Cox regression models addressing CSM, CDC was associated with a HR of 1.5 (p < 0.001) in the overall population vs. 1.9 (p = 0.014) in stage I-II vs. 1.4 (p = 0.022) in stage III vs. 1.6 in stage IV (p < 0.001), relative to ISUP4 ccRCC.ConclusionCDC patients exhibited 40–90 % higher CSM than their ISUP4 ccRCC counterparts in the overall analysis, as well as in stage specific analyses. The CSM disadvantage applies despite higher rates of systemic therapy in CDC patients. |
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| Keywords: | Collecting duct Clear cell Variant histology Cancer specific mortality |
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