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The impact of family history on pathological and clinical outcomes in non‐syndromic clear cell renal cell carcinoma
Author(s) -
Tollefson Matthew K.,
Boorjian Stephen A.,
Lohse Christine M.,
Blute Michael L.,
Leibovich Bradley C.
Publication year - 2010
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.2010.09441.x
Subject(s) - family history , clear cell renal cell carcinoma , medicine , pathological , renal cell carcinoma , nephrectomy , kidney cancer , clear cell , tuberous sclerosis , oncology , cancer , pathology , kidney
Study Type – Prognosis (case series)
Level of Evidence 4 OBJECTIVE To investigate the impact of family history on pathological and clinical outcomes after surgery for clear‐cell renal cell carcinoma (ccRCC) in patients with non‐syndromic disease. PATIENTS AND METHODS We reviewed 2677 patients treated with radical nephrectomy or nephron‐sparing surgery for non‐cystic ccRCC between 1970 and 2004 to identify patients with a family history of ccRCC. Patients with von Hippel–Lindau, tuberous sclerosis, or Birt–Hogg–Dube syndrome were excluded from analysis. Demographics and clinico‐pathological outcomes were compared to patients with ccRCC without a family history of kidney cancer using chi‐squared and Fisher’s exact tests. Postoperative cancer‐specific survival was estimated using the Kaplan–Meier method. RESULTS We identified 42 patients (1.6%) with a family history of ccRCC who were treated for non‐cystic ccRCC, with a median follow‐up of 4.7 years (range 1–34). Demographics and tumour characteristics, including tumour stage and grade, were similar between the two groups. Patients with a family history of ccRCC were more likely to have bilateral tumours (11.9 vs 2.2%, P = 0.003). Nevertheless, cancer‐specific survival rates for patients with and without a family history of ccRCC were similar at 5 years (75.7 vs 71.1%) and 10 years (53.9 vs 62.2%). CONCLUSIONS Patients with a family history of ccRCC have pathological and clinical outcomes similar to patients with sporadic ccRCC. The increased incidence of bilateral tumours associated with a family history of ccRCC provides further evidence to support a nephron‐sparing surgical approach when feasible.