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Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population.

Yann Neuzillet 1, * Xavier Tillou 2 Romain Mathieu 3 Jean-Alexandre Long 4 Marc Gigante 5 Philippe Paparel 6 Laura Poissonnier 6 Hervé Baumert 7 Bernard Escudier 8 Hervé Lang 9 Nathalie Rioux-Leclercq 10 Pierre Bigot 11 Jean-Christophe Bernhard 12 Laurence Albiges 8 Laurence Bastien 13 Jacques Petit 2 Fabien Saint 2 Franck Bruyere 14 Jean-Michel Boutin 14 Nicolas Brichart 14 Georges Karam 15 Julien Branchereau 15 Jean-Marie Ferriere 12 Hervé Wallerand 12 Sébastien Barbet 12 Hicham Elkentaoui 12 Jacques Hubert 16 Benoit Feuillu 16 Pierre-Etienne Theveniaud 16 Arnauld Villers 17 Laurent Zini 17 Aurélien Descazeaux 18 Morgan Roupret 19 Benoit Barrou 19 Karim Fehri 19 Thierry Lebret 1 Jacques Tostain 5 Jean-Etienne Terrier 5 Nicolas Terrier 4 Lucille Martin 20 Fabrice Dugardin 21 Ismaël Galliot 21 Frédéric Staerman 22 Marie-Dominique Azemar 22 Jacques Irani 23 Baptiste Tisserand 23 Marc-Olivier Timsit 24 Federico Sallusto 25 Pascal Rischmann 25 Laurent Guy 26 Antoine Valeri 27 Charles Deruelle 27 Abdel-Rahmène Azzouzi 11 Denis Chautard 11 Arnaud Mejean 24 Laurent J. Salomon 28 Jérôme Rigaud 15 Christian Pfister 21 Michel Soulié 25 François M. Kleinclauss 20 Lionel Badet 6 Jean-Jacques Patard 29 
Abstract : BACKGROUND: Patients with end-stage renal disease (ESRD) are at risk of developing renal tumours. OBJECTIVE: Compare clinical, pathologic, and outcome features of renal cell carcinomas (RCCs) in ESRD patients and in patients from the general population. DESIGN, SETTING, AND PARTICIPANTS: Twenty-four French university departments of urology participated in this retrospective study. INTERVENTION: All patients were treated according to current European Association of Urology guidelines. MEASUREMENTS: Age, sex, symptoms, tumour staging and grading, histologic subtype, and outcome were recorded in a unique database. Categoric and continuous variables were compared by using chi-square and student statistical analyses. Cancer-specific survival (CSS) was assessed by Kaplan-Meier and Cox methods. RESULTS AND LIMITATIONS: The study included 1250 RCC patients: 303 with ESRD and 947 from the general population. In the ESRD patients, age at diagnosis was younger (55 ± 12 yr vs 62 ± 12 yr); mean tumour size was smaller (3.7 ± 2.6 cm vs 7.3 ± 3.8 cm); asymptomatic (87% vs 44%), low-grade (68% vs 42%), and papillary tumours were more frequent (37% vs 7%); and poor performance status (PS; 24% vs 37%) and advanced T categories (≥ 3) were more rare (10% vs 42%). Consistently, nodal invasion (3% vs 12%) and distant metastases (2% vs 15%) occurred less frequently in ESRD patients. After a median follow-up of 33 mo (range: 1-299 mo), 13 ESRD patients (4.3%), and 261 general population patients (27.6%) had died from cancer. In univariate analysis, histologic subtype, symptoms at diagnosis, poor PS, advanced TNM stage, high Fuhrman grade, large tumour size, and non-ESRD diagnosis context were adverse predictors for survival. However, only PS, TNM stage, and Fuhrman grade remained independent CSS predictors in multivariate analysis. The limitation of this study is related to the retrospective design. CONCLUSIONS: RCC arising in native kidneys of ESRD patients seems to exhibit many favourable clinical, pathologic, and outcome features compared with those diagnosed in patients from the general population.
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Submitted on : Wednesday, March 16, 2011 - 5:30:34 PM
Last modification on : Thursday, August 4, 2022 - 5:21:25 PM



Yann Neuzillet, Xavier Tillou, Romain Mathieu, Jean-Alexandre Long, Marc Gigante, et al.. Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population.. European Urology, Elsevier, 2011, 60 (2), pp.366-73. ⟨10.1016/j.eururo.2011.02.035⟩. ⟨inserm-00577215⟩



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