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Prognostic factors in a prospective series of papillary renal cell carcinoma
Author(s) -
Gontero Paolo,
Ceratti Giovanni,
Guglielmetti Sandro,
Andorno Antonella,
Terrone Carlo,
Bonvini Daniele,
Faggiano Fabrizio,
Tizzani Alessandro,
Frea Bruno,
Valente Guido
Publication year - 2008
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.07756.x
Subject(s) - medicine , papillary renal cell carcinomas , univariate analysis , proportional hazards model , oncology , cd31 , stage (stratigraphy) , immunohistochemistry , prospective cohort study , hazard ratio , retrospective cohort study , pathology , renal cell carcinoma , multivariate analysis , confidence interval , biology , paleontology
OBJECTIVE To prospectively assess the clinical outcome of a series of papillary renal cell carcinomas (PRCCs) to identify possible prognostic clinical variables and tumour markers, as previous retrospective series of PRCC do not provide unanimous results on the prognostic utility of clinicopathological variables. PATIENTS AND METHODS Forty‐six patients with PRCC (median follow‐up 40 months) diagnosed in one institution from 1989 to 2002 were prospectively followed until May 2006. The pathology was reviewed, the PRCC subtyped (type 1 and 2) and immunohistochemistry assessed for MIB‐1, vascular endothelial growth factor (VEGF), CD31 and c‐met oncogenic protein, by a referee pathologist. Prognostic values were estimated by fitting a Cox model. RESULTS The 5‐year survival rate was 49.5%; type 2 histology was predominant and was almost significant in the univariate analysis. Stage and MIB‐1 were significant prognostic factors only in the univariate model, while the Cox model identified only the Fuhrman grade as an independent predictor of survival (hazard ratio 3.054; P = 0.007). MET expression, CD31 and VEGF had no prognostic utility. CONCLUSION These patients with PRCC followed prospectively fared worse than in previously reported series. The Fuhrman grade was the sole independent predictor of survival.