Grading Chromophobe Renal Cell Carcinoma: Evidence for a Four-tiered Classification Incorporating Coagulative Tumor Necrosis

Avulova, Svetlana; Cheville, John C.; Lohse, Christine M.; Gupta, Sounak; Potretzke, Theodora A.; Tsivian, Matvey; Thompson, R. Houston; Boorjian, Stephen A.; Leibovich, Bradley C.; Potretzke, Aaron M.

doi:10.1016/j.eururo.2020.10.007

Cited by 35 publications

(38 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Accurate prediction of the clinical behavior and trajectory of ChRCCs by histologic features has proven to be challenging. Historically, risk assessment of ChRCCs has not been successful with a number of studies attempting to address the value of histological grading for these tumors [ 6 , 16 , [41] , [42] , [43] ]. The clinical significance of traditional grading systems applied to other RCC subtypes, such as Fuhrman nuclear grade and the WHO/International Society of Urological Pathology (ISUP) nucleolar system, could not be demonstrated for ChRCCs [ 44 ].…”

Section: Grading Considerationsmentioning

confidence: 99%

Chromophobe renal cell carcinoma: Novel molecular insights and clinicopathologic updates

Alaghehbandan

Przybycin

Verkarre

et al. 2022

Asian Journal of Urology

View full text Add to dashboard Cite

Section: Grading Considerationsmentioning

confidence: 99%

Chromophobe renal cell carcinoma: Novel molecular insights and clinicopathologic updates

Alaghehbandan

Przybycin

Verkarre

et al. 2022

Asian Journal of Urology

View full text Add to dashboard Cite

“…Sarcomatoid change, necrosis, and mitosis were significantly associated with shorter time to tumor progression and OS in univariate analysis. However, the study noted high 28 concordance for sarcomatoid differentiation and tumor necrosis, but only low to medium concordance for identification of mitosis. The proportion of CTG 2 (26%) in the study was notably higher compared to that in the original CTG study (16%).…”

Section: Chromophobe Tumor Gradementioning

confidence: 73%

Updates in Grading of Renal Cell Carcinomas Beyond Clear Cell Renal Cell Carcinoma and Papillary Renal Cell Carcinoma

Paner

Chumbalkar

Montironi

et al. 2022

Advances in Anatomic Pathology

View full text Add to dashboard Cite

The World Health Organization (WHO) recommends grading of clear cell renal cell carcinoma (RCC) and papillary RCC using the WHO/International Society of Urological Pathology (ISUP) grade, which is primarily based on nuclear features. As the spectrum of RCC continues to evolve, with more recently described subtypes in the past decade, literature evidence on grading these subtypes is limited or not available for some tumor types. Herein, we outline a pragmatic approach to the topic of grading RCC, dividing the contemporarily described RCC subtypes into 7 categories based on the potential clinical applicability of grading as a useful prognostic parameter: (1) RCC subtypes that are reasonably validated and recommended for WHO/ISUP grading; (2) RCC subtypes where WHO/ISUP is not applicable; (3) RCC subtypes where WHO/ISUP grading is potentially clinically useful; (4) inherently aggressive RCC subtypes where histologic classification itself confers an aggressive biologic potential; (5) renal epithelial tumors where WHO/ISUP grading provides potentially misleading prognostic implication; (6) renal epithelial neoplasms where low WHO/ISUP grade features are a prerequisite for accurate histologic classification; and (7) renal epithelial neoplasms with no or limited data on grading or incomplete understanding of the biologic potential. Our aim in outlining this approach is 2-fold: (a) identify the gaps in understanding and application of grading in RCC subtypes so that researchers in the field may perform additional studies on the basis of which the important pathologic function of assignment of grade may be recommended to be performed as a meaningful exercise across a wider spectrum of RCC; and (b) to provide guidance in the interim to surgical pathologists in terms of providing clinically useful grading information in RCC based on currently available clinicopathologic information.

show abstract

“…In the present study, we did not evaluate the WHO/ISUP grade in patients with ChRCC, because it cannot predict prognoses 22 . Two studies have recently proposed a new grading schema that SC and necrosis could be significant prognostic parameters for patients with ChRCC 23,24 . SC and necrosis might be associated with oncological prognosis in various histological subtypes of RCC.…”

Section: Discussionmentioning

confidence: 88%

Predictors of postoperative recurrence in patients with non‐metastatic pT3a renal cell carcinoma

et al. 2021

View full text Add to dashboard Cite

Objective To analyze the effect of patterns of extrarenal tumor extension with other pathological factors on postoperative recurrence in patients with non‐metastatic pT3a renal cell carcinoma. Methods We retrospectively reviewed 587 non‐metastatic renal cell carcinoma patients who underwent radical surgery between 2006 and 2017 at Kansai Medical University Hospital, Hirakata, Osaka, Japan. We extracted a subset of 114 patients with pT3a of predominant histological types: 93 with clear cell renal cell carcinoma (81.6%), 13 with unclassified renal cell carcinoma (11.4%), six with chromophobe renal cell carcinoma (5.3%) and two with papillary renal cell carcinoma. The primary end‐point was recurrence‐free survival. The Kaplan–Meier method and Cox proportional hazards model were used for statistical analysis. Results Of the 114 patients with pT3a renal cell carcinoma, 42 patients (36.8%) experienced recurrence. Multivariate analysis showed that perinephric fat invasion (hazard ratio 2.36, P = 0.009), sarcomatoid or rhabdoid component (hazard ratio 2.88, P = 0.022) and necrosis (hazard ratio 2.34, P = 0.030) were independent factors for recurrence‐free survival. The high‐risk pT3a group, which had more than two independent predictors, had poor prognosis. Recurrence‐free survival of the high‐risk pT3a group and the pT3b or greater group were similar (median recurrence‐free survival 23.0 and 10.8 months, respectively). Conclusions Perinephric fat invasion, sarcomatoid or rhabdoid component and necrosis are independent predictors of recurrence‐free survival in patients with pT3a‐predominant renal cell carcinoma. Patients with more than two of these predictors have poor oncological outcomes. These findings will aid in risk stratification for predicting recurrence and provide prognostic information for patient counseling.

show abstract

Grading Chromophobe Renal Cell Carcinoma: Evidence for a Four-tiered Classification Incorporating Coagulative Tumor Necrosis

Cited by 35 publications

References 16 publications

Chromophobe renal cell carcinoma: Novel molecular insights and clinicopathologic updates

Chromophobe renal cell carcinoma: Novel molecular insights and clinicopathologic updates

Updates in Grading of Renal Cell Carcinomas Beyond Clear Cell Renal Cell Carcinoma and Papillary Renal Cell Carcinoma

Predictors of postoperative recurrence in patients with non‐metastatic pT3a renal cell carcinoma

Contact Info

Product

Resources

About