Chromophobe Renal Cell Carcinoma: Histomorphologic Characteristics and Evaluation of Conventional Pathologic Prognostic Parameters in 145 Cases

• DOI: 10.1097/pas.0b013e3181831e68
• Publication Date: 2008-11-21T08:11:07Z
• Authors: Mahul B. Amin; Gladell P. Paner; Isabel Alvarado-C...; Andrew N. Young; Hans J. Stricker; Robert H. Lyles; Holger Moch
• Keywords: Chromophobe cell

The aggregate literature suggests that chromophobe renal cell carcinoma (RCC) is biologically a tumor of low malignant potential with reported 5-year and 10-year survival rates 78% to 100% 80% 90%, respectively. conventional prognostic parameters determine the outcome tumors progress remain be fully characterized. Clinicopathologic features 145 cases were correlated outcome. mean age patients was 59 years (range, 27 82) male female ratio 1.1:1. Most well circumscribed averaged 8.0 cm 1.0 30.0 cm); multifocality bilaterality present in 8% 3% patients. Sixty (41%) eosinophilic variant (greater than cells), 18 (12%) classic type pale 67 (46%) mixed (containing variable admixture cells). A subset RCC contained or had areas similar oncocytomas. These tended more commonly bilateral (11%) multifocal (22%) not associated necrosis sarcomatoid change. Sarcomatoid change 12/145 (8%) tumors. By histologic grade, 1%, 19%, 74%, 6% Fuhrman nuclear grade 1, 2, 3, 4. Nineteen percent, 21%, 28%, 13%, 4%, pT (2002) stage pT1a, pT1b, pT2, pT3a, pT3b, pT3c, pT4 Two percent pN1 at presentation 2.8% M1 presentation. Follow-up (1 182 mo, 48 median 37 mo) available 123 cases. Disease progression (local recurrence 4, metastasis 15, and/or death 10) seen 20 In univariable analysis, size (P=0.025), (P<0.001), broad alveolar architecture (P=0.012), microscopic (P=0.001), vascular invasion (P=0.020), (P< =0.001) progression. multivariable Cox regression model revealed (P=0.013, estimated relative hazard 4.7), (P=0.020, hazard=3.5), (P=0.025, 3.4) as independent predictors aggressive RCC. Although large majority RCCs have favorable prognosis, distinct progress. tumor, necrosis, all predict phenotype adverse presence these nephrectomy specimen warrants active surveillance, may candidates for adjuvant therapies they become available.