Impact of histological subtype on outcomes of renal cell carcinoma patients

Figures & data

Table 1. Baseline characteristics of renal cell carcinoma (RCC) patients included in the analysis according to the histology (N = 89,968).

Characteristics	Clear cell RCC (N = 68,318)	Papillary RCC (N = 14,791)	Chromophobe RCC (N = 6458)	Collecting duct RCC (N = 401)	p value
Age (years)					<.0001
<40	3041 (4.5%)	547 (3.7%)	547 (8.5%)	23 (5.7%)
40–69	46,027 (67.4%)	9901 (66.9%)	4089 (63.3%)	250 (62.3%)
>70	19,250 (28.2%)	4343 (29.4%)	1822 (28.2%)	128 (31.9%)
Gender					<.0001
Male	42,258 (61.9%)	11,372 (76.9%)	3672 (56.9%)	273 (68.1%)
Female	26,060 (38.1%)	3419 (23.1%)	2786 (43.1%)	128 (31.9%)
Race					<.0001
White	58,462 (85.6%)	10,398 (70.3%)	5230 (81%)	285 (71.1%)
Black	4944 (7.2%)	3885 (26.3%)	850 (13.2%)	92 (22.9%)
Others	4515 (6.6%)	428 (2.9%)	319 (4.9%)	24 (6%)
Unknown	397 (0.6%)	80 (0.5%)	59 (0.9%)	0
Marital status					<.0001
Married	43,218 (63.3%)	9030 (61.1%)	4139 (64.1%)	240 (59.9%)
Not married	22,137 (32.4%)	4988 (33.6%)	1993 (30.9%)	148 (36.9%)
Unknown	2963 (4.3%)	773 (5.2%)	326 (5%)	13 (3.2%)
AJCC stage					<.0001
I	36,690 (53.7%)	9264 (62.6%)	3599 (55.7%)	77 (19.2%)
II	4956 (7.3%)	1234 (8.3%)	979 (15.2%)	13 (3.2%)
III	8987 (9.4%)	1134 (7.7%)	655 (10.1%)	64 (16%)
IV	6441 (9.4%)	753 (5.1%)	157 (2.4%)	131 (32.7%)
Unknown	11,244 (16.5%)	1068 (16.5%)	1068 (16.5%)	116 (28.9%)
Sites of distant organ involvement (available only for metastatic patients diagnosed beyond 2010)					<.0001
Bone	1037 (1.5%)^a	96 (0.6%)	21 (0.3%)	18 (4.5%)
Liver	419 (0.6%)	43 (0.3%)	10 (0.2%)	9 (2.2%)
Lung	1607 (2.4%)	132 (0.9%)	19 (0.3%)	28 (7%)
Brain	338 (0.5%)	20 (0.1%)	5 (0.1%)	2 (0.5%)
Surgical/ablative treatment to the primary					<.0001
None	4842 (7.1%)	986 (6.7%)	189 (2.9%)	64 (16%)
Ablative treatment	2460 (3.6%)	764 (5.2%)	197 (3.1%)	4 (1%)
Partial nephrectomy	16,650 (24.4%)	5299 (35.8%)	1992 (30.8%)	28 (7%)
Total nephrectomy	43,654 (63.9%)	7547 (51%)	4001 (62%)	298 (74.3%)
Surgery, NOS	647 (0.9%)	179 (1.2%)	74 (1.1%)	6 (1.5%)
Unknown	65 (0.1%)	16 (0.1%)	5 (0.1%)	1 (0.2%)
Radiation					<.0001
Yes	2461 (3.6%)	187 (1.3%)	59 (0.9%)	39 (9.7%)
No	65,517 (95.9%)	14,518 (98.2%)	6373 (98.7%)	361 (90%)
Unknown	340 (0.5%)	86 (0.6%)	26 (0.4%)	1 (0.2%)

NOS: not otherwise specified.

^a This percentage is out of the total number of cases (2001–2013).

Figure 1. Incidence of: (a) clear cell renal cell carcinoma; (b) papillary renal cell carcinoma; (c) chromophobe renal cell carcinoma cases from 2001–2013 assessed through Join-Point program.

Figure 2. Kaplan–Meier curve according to histological subtype of: (a) overall survival of non-metastatic cases; (b) cancer-specific survival of non-metastatic cases; (c) overall survival of metastatic cases; (d) cancer-specific survival of metastatic cases.

Figure 3. Kaplan–Meier curve of: (a) overall survival and (b) cancer-specific survival according to the type of local treatment of non-metastatic patients.

Table 2. Multivariate analysis of factors affecting overall and cancer-specific survival among non-metastatic RCC patients.

Parameter	Overall survival		Cancer-specific survival
	Hazard ratio (95% CI)	p value	Hazard ratio (95% CI)	p value
Histological subtype
Papillary	Reference		Reference
Clear cell	0.998 (0.949–1.050)	.945	1.122 (1.019–1.237)	.020
Chromophobe	0.603 (0.547–0.664)	<.0001	0.493 (0.406–0.599)	<.0001
Collecting duct	2.404 (1.966–2.940)	<.0001	3.139 (2.396–4.112)	<.0001
Age (years)
<40	Reference		Reference
40–69	2.664 (2.260–3.140)	<.0001	1.735 (1.373–2.193)	<.0001
≥70	6.213 (5.268–7.327)	<.0001	2.631 (2.076–3.334)	<.0001
T stage
T1	Reference		Reference
T2	1.857 (1.770––1.947)	<.0001	4.358 (4.056–4.683)	<.0001
T3	2.390 (2.302–2.481)	<.0001	5.823 (5.482–6.185)	<.0001
T4	5.839 (5.372–6.347)	<.0001	15.329 (13.826–16.995)	<.0001
N stage
N2	Reference		Reference
N0	0.280 (0.243–0.323)	<.0001	0.184 (0.155–0.218)	<.0001
N1	0.854 (0.721–1.013)	.070	0.816 (0.667–0.997)	.047
Local treatment
None	Reference		Reference
Ablation	0.358 (0.320–0.400)	<.0001	0.237 (0.181–0.311)	<.0001
Partial nephrectomy	0.184 (0.168–0.202)	<.0001	0.119 (0.098–0.144)	<.0001
Total nephrectomy	0.311 (0.287–0.337)	<.0001	0.293 (0.201–0.427)	<.0001
Race
White	Reference		Reference
Black	1.212 (1.143–1.286)	<.0001	1.092 (0.977–1.222)	.122
Others	0.901 (0.828–0.981)	.016	1.081 (0.945–1.236)	.257
Gender
Female	Reference		Reference
Male	1.251 (1.201–1.303)	<.0001	1.047 (0.975–1.124)	.207
Marital status
Married	Reference		Reference
Unmarried	1.365 (1.311–1.420)	<.0001	1.188 (1.106–1.275)	<.0001

Table 3. Relative survival of metastatic RCC patients according to histological subtypes.

Histological subtype		2001–2013			2001–2006			2007–2013
	Follow up	Number	RS (%)	SE (%)	Number	RS (%)	SE	Number	RS (%)	SE (%)
Clear cell	12 months	5188	53.8	0.8	1271	51	1.6	3917	54.8	0.9
	36 months	5188	27.1	0.8	1271	26.4	1.4	3917	27.4	1
Papillary	12 months	488	41.4	2.6	114	42.8	5.2	374	40.8	2.9
	36 months	488	19.3	2.4	114	21.8	4.6	374	18	2.7
Chromophobe	12 months	99	53.1	5.5	32	60.4	10	67	47.5	6.6
	36 months	99	35.1	5.6	32	37.8	9.6	67	33.1	6.7
Collecting duct	12 months	84	18.5	48	23	17.5	7.3	61	17.9	5.6
	36 months	84	NA	NA	23	5.8	3.5	61	NA	NA

SE: age-standardized standard error; RS: age-standardized relative survival; NA: not available.