Therapeutic Implications of Histologic Subtypes in Papillary Renal Cell Carcinoma
Nina Wagener, MD, of the University of Heidelberg, Mannheim, Germany, and colleagues, writing in PLoS ONE, said they have found that in patients who have had surgery for nonmetastatic renal cell carcinoma, those with subtype 1 papillary disease had a 69% reduced risk of death compared with both patients with type 2 and clear cell disease. In addition, patients with nonmetastatic papillary disease had better cancer-specific mortality than those with clear cell disease. Thus, determining the type of renal cell carcinoma has clinical implications for selecting the appropriate treatment type and improving survival.
The study focused on retrospective data of 1943 patients with papillary renal cell carcinoma treated with surgery in 17 European/North American centers between 1984 and 2015. These data were compared with 5600 patients with renal cell carcinoma from a database of 11 European/North American centers between 1984 and 2011.
The fact that papillary renal cell carcinoma type 1 was associated with a reduced risk of death and papillary renal cell carcinoma type 2 showed no difference in cancer-specific mortality may indicate “an analogous clinical behavior of these two renal cell carcinoma entities,” the authors concluded. They also suggest that assignment of follow-up or targeted therapy for such patients should take into consideration histopathologic entities and their subtypes.