Predominantly cystic clear cell renal cell carcinoma and multilocular cystic renal neoplasm of low malignant potential form a low-grade spectrum Journal Article


Authors: Tretiakova, M.; Mehta, V.; Kocherginsky, M.; Minor, A.; Shen, S. S.; Sirintrapun, S. J.; Yao, J. L.; Alvarado-Cabrero, I.; Antic, T.; Eggener, S. E.; Picken, M. M.; Paner, G. P.
Article Title: Predominantly cystic clear cell renal cell carcinoma and multilocular cystic renal neoplasm of low malignant potential form a low-grade spectrum
Abstract: Multilocular cystic renal cell carcinoma has been recently excluded from clear cell renal cell carcinoma (CCRCC) category and re-designated as multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) due to its uniformly good outcomes. While strict distinction between MCRNLMP from predominantly cystic CCRCC (pc-CCRCC) is being emphasized, the significance of extensive true cystic component in CCRCC has not been investigated. Herein, we analyzed 57 MCRNLMP, 69 pc-CCRCC, and 46 non-cystic CCRCC. There were no statistically significant differences between the three subtypes in age, gender, and laterality. ISUP grades were 1 (73%) or 2 (27%) for MCRNLMP; for pc-CCRCC were 1 (31%), 2 (60%), and 3 (9%); and for non-cystic CCRCC were 1 (9%), 2 (52%), 3 (26%), and 4 (13%). MCRNLMP were either pT stage 1 (91%) or 2 (9%), pT stages for pc-CCRCC were 1 (92.5%), 2 (1.5%), and 3 (6%) and for non-cystic CCRCC were 1 (58.7%), 2 (6.5%), and 3 (34.8%). None of MCRNLMP patients developed recurrences or metastases, and only 1 contralateral kidney tumor and 1 metastasis developed in pc-CCRCC. In contrast, 19 patients with non-cystic CCRCC developed metastases (5-year PFS 58%, CI 38.3–73.5%), and 1 patient died of disease. Monosomy 3 was common in both MCRNLMP (3/3) and pc-CCRCC (6/7). This large series of MCRNLMP confirms its indolent behavior, shows that pc-CCRCC has significantly better prognosis than non-cystic CCRCC and may define the lower grade spectrum of CCRCC. We recommend that the presence and extent of CCRCC cystic component should be documented in the pathology report. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
Keywords: adult; cancer survival; controlled study; human tissue; aged; middle aged; cancer surgery; major clinical study; case control study; histopathology; cancer recurrence; cancer patient; comparative study; cancer staging; cancer grading; neoplasm; metastasis; progression free survival; tumor volume; tumor differentiation; renal cell carcinoma; cancer mortality; age; fluorescence in situ hybridization; radical nephrectomy; kidney tumor; carcinoma; gender; cancer morphology; kidney cyst; cystic; clinical outcome; renal; monosomy; clear cell; cancer prognosis; benign neoplasm; human; male; female; priority journal; article; multilocular; multilocular cystic renal neoplasm of low malignant potential; predominantly cystic clear cell renal cell carcinoma
Journal Title: Virchows Archiv
Volume: 473
Issue: 1
ISSN: 0945-6317
Publisher: Springer  
Date Published: 2018-07-01
Start Page: 85
End Page: 93
Language: English
DOI: 10.1007/s00428-018-2371-8
PROVIDER: scopus
PUBMED: 29770853
DOI/URL:
Notes: Article -- Export Date: 1 August 2018 -- Source: Scopus
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