Abstract:Objective: To improve the diagnosis and treatment of type 1 papillary renal cell carcinoma (PRCC) by exploring the clinical features of PRCC patients in our hospital. Method: We retrospectively reviewed the clinicopathologic data of 89 patients with PRCC admitted at our hospital from January 2009 to November 2017. The mean age of these patients at diagnosis was 50 years including 68 males and 21 females. All tumors were localized unilaterally with 41 in left kidney and 48 in right kidney. Result: All of the 89 patients were given mini-invasive surgery nephrectomy successfully. Fifty-six patients received laparoscopic surgery and the rest were treated with robot-assisted laparoscopic surgery. The mean operative time and the mean operative blood loss between two groups showed no significant difference. The average maximum diameter of tumors was 4.5 cm. Among them, 73 patients were at pT1N0M0, 9 at pT2N0M0, 6 at pT3N0M0 and 1 at pT1N0M1. All patients were followed up with a mean duration of 30.6 months. Metastases occurred in 6 cases, and 2 died eventually. Conclusions: Type 1 PRCC is a rare subtype of renal cell carcinoma with infrequent recurrence and metastasis. Surgery is the standard treatment. The laparoscopic surgery has similar treatment efficacy to robot-assisted laparoscopic surgery. Type 1 PRCC patients have favorable prognosis.
[1] Mancilla-Jimenez R, Stanley RJ, Blath RA.Papillary renal cell carcinoma: a clinical, radiologic, and pathologic study of 34 cases.Cancer. 1976,38(6):2469-2480. [2] LINEHAN WM, SPELLMAN PT, RICKETTS CJ, et al.Comprehensive molecular characterization of papillary renal-cell carcinoma. N Engl J Med, 2016,374(2):135-145. [3] INAMURA K.Renal cell tumors: understanding their molecular pathological epidemiology and the 2016 WHO classification. Int J Mol Sci, 2017,18(10):2195. [4] DELAHUNT B, EBLE JN.Papillary renal cell carcinoma: a clinicopathologic and immunohistochemical study of 105 tumors. Mod Pathol, 1997,10(6):537-544. [5] SRIGLEY JR, DELAHUNT B, EBLE JN, et al.The international society of urological pathology (ISUP) Vancouver classification of renal neoplasia. Am J Surg Pathol, 2013,37(10):1469-1489. [6] FERNANDES DS, LOPES JM.Pathology, therapy and prognosis of papillary renal carcinoma. Future Oncol, 2015,11(1):121-132. [7] LEDEZMA RA, NEGRON E, PANER GP, et al.Clinically localized type 1 and 2 papillary renal cell carcinomas have similar survival outcomes following surgery. World J Urol, 2016,34(5):687-693. [8] PRASAD SR, HUMPHREY PA, CATENA JR, et al. Common and uncommon histologic subtypes of renal cell carcinoma: imaging spectrum with pathologic correlation. Radiographics, 2006,26(6):1795-1806; discussion 1806-1810. [9] AMIN MB, AMIN MB, TAMBOLI P, et al.Prognostic impact of histologic Subtyping of adult renal epithelial neoplasms-An experience of 405 cases. Am J Surg Pathol, 2002,26(3):281-291. [10] KURODA N, TOI M, HIROI M, et al.Review of papillary renal cell carcinoma with focus on clinical and pathobiological aspects. Histol Histopathol, 2003,18(2):487-494. [11] MICHALOVA K, STEINER P, ALAGHEHBANDAN RA, et al.Papillary renal cell carcinoma with cytologic and molecular genetic features overlapping with renal oncocytoma: Analysis of 10 cases. Ann Diagn Pathol, 2018,35:1-6. [12] BRUNELLI M, EBLE JN, ZHANG SB, et al.Gains of chromosomes 7, 17, 12, 16, and 20 and loss of Y occur early in the evolution of papillary renal cell neoplasia: A fluorescent in situ hybridization study. Mod Pathol, 2003,16(10):1053-1059. [13] TANNIR NM, JONASCH E, ALBIGES L, et al.Everolimus versus sunitinib prospective evaluation in metastatic non-clear cell renal cell carcinoma (ESPN): A randomized multicenter phase 2 trial. Eur Urol, 2016,69(5):866-874. [14] ARMSTRONG AJ, HALABI S, EISEN T, et al.Everolimus versus sunitinib for patients with metastatic non-clear-cell renal cell carcinoma (Aspen): a multicentre, open-label, randomised phase 2 trial. Lancet Oncol, 2016,17(3):378-388. [15] TELOKEN PE, THOMPSON RH, TICKOO SK, et al.Prognostic impact of histological subtype on surgically treated localized renal cell carcinoma. J Urol, 2009,182(5):2132-2136. [16] KONDO T, IKEZAWA E, TAKAGI T, et al.Negative impact of papillary histological subtype in patients with renal cell carcinoma extending into the inferior vena cava: Single-center experience. Int J Urol, 2013,20(11):1072-1077. [17] YAMASHITA S, IORITANI N, OIKAWA KA, et al.Morphological subtyping of papillary renal cell carcinoma: Clinicopathological characteristics and prognosis. Int J Urol, 2007,14(8):679-683. [18] KLATTE T, REMZI M, ZIGEUNER RE, et al.Development and external validation of a nomogram predicting disease specific survival after nephrectomy for papillary renal cell carcinoma. J Urol, 2010,184(1):53-58.