Papillary Renal Cell Carcinoma: Demographics, Survival Analysis, Racial Disparities, and Genomic Landscape
Main Article Content
Keywords
COSMIC, next-generation sequencing, papillary renal cell carcinoma, SEER
Abstract
Papillary renal cell carcinoma (PRCC) is the second most common histological subtype of renal cell cancer. This research aims to present a large database study highlighting the demographic, clinical, and pathological factors, racial disparities, prognosis, and survival of PRCC. The clinical and demographic data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, and molecular data was cured from the Catalogue Of Somatic Mutations in Cancer (COSMIC) database. PRCC had a median age of diagnosis at 64 years, with a higher incidence in men (77%), and Whites (68%). 70.3% of cases were Grades I–IV (13, 53, 31, and 3%, respectively). In patients with known data, 85% were localized to the kidney, and 84% of cases were 7 cm in size. No metastasis occurred in 97% of the known data. The most common treatment offered was surgical resection (9%). The 5-year overall survival was 79%, with patients undergoing surgery having a 90.6% 5-year survival. Multivariable analysis revealed age > 60 years, Black race, poor histologic differentiation, distant metastases, and tumor size > 10 cm as independent risk factors for mortality. The most common mutations identified from the COSMIC database were MET, KMT2D, KMT2C, ARID1A, and SPEN. PRCC affects male individuals in the sixth decade of life. Increased age, Black race, distant metastases, and tumors > 10 cm are associated with a worse prognosis. Surgical resection offers a favorable survival outcome. Next-generation sequencing (NGS) could identify potentially targetable alterations and future personalized therapeutic approaches.
References
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27. Park I, Shim YS, Go H, Hong BS, Lee JL. Long-term response of metastatic hereditary leiomyomatosis and renal cell carcinoma syndrome associated renal cell carcinoma to bevacizumab plus erlotinib after temsirolimus and axitinib treatment failures. BMC Urol. 2019;19(1):51. 10.1186/s12894-019-0484-2
28. Choi Y., Keam B., Kim M., Yoon S., Kim D., Choi J. G., et al. Bevacizumab plus Erlotinib combination therapy for advanced hereditary leiomyomatosis and renal cell carcinoma-associated renal cell carcinoma: A multicenter retrospective analysis in Korean patients. Cancer Res Treat. 2019;51(4):1549–56. 10.4143/crt.2019.086
29. Schrader AJ, Rauer-Bruening S, Olbert PJ, Hegele A, Rustemeier J, Timmesfeld N, et al. Incidence and long-term prognosis of papillary renal cell carcinoma. J Cancer Res Clin Oncol. 2009;135(6):799–805. 10.1007/s00432-008-0515-y
30. Ronnen EA, Kondagunta GV, Ishill N, Spodek L, Russo P, Reuter V, et al. Treatment outcome for metastatic papillary renal cell carcinoma patients. Cancer. 2006;107(11):2617–21. 10.1002/cncr.22340
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34. Camidge DR, Otterson GA, Clark JW, Ignatius Ou SH, Weiss J, Ades S, et al. Crizotinib in patients with MET-amplified NSCLC. J Thorac Oncol. 2021;16(6):1017–29. 10.1016/j.jtho.2021.02.010
35. Choueiri TK, Heng DYC, Lee JL, Cancel M, Verheijen RB, Mellemgaard A, et al. Efficacy of savolitinib vs sunitinib in patients with MET-driven papillary renal cell carcinoma: The SAVOIR Phase 3 randomized clinical Trial. JAMA Oncol. 2020;6(8):1247–55. 10.1001/jamaoncol.2020.2218
36. Yang XJ, Tan MH, Kim HL, Ditlev JA, Betten MW, Png CE, et al. A molecular classification of papillary renal cell carcinoma. Cancer Res. 2020;65(13):5628–37. 10.1158/0008-5472.CAN-05-0533
37. Srivastava A, Doppalapudi SK, Patel HV, Srinivasan R, Singer EA. The roaring 2020s: A new decade of systemic therapy for renal cell carcinoma. Curr Opin Oncol. 2022;34(3):234–42. 10.1097/CCO.0000000000000831
38. Ronnen EA, Kondagunta GV, Ishill N, Spodek L, Russo P, Reuter V, et al. Treatment outcome for metastatic papillary renal cell carcinoma patients. Cancer. 2006;107(11):2617–21. 10.1002/cncr.22340
2. Mendhiratta N, Muraki P, Sisk AE Jr, Shuch B. Papillary renal cell carcinoma: Review. Urol Oncol. 2021;39(6):327–37. 10.1016/j.urolonc.2021.04.013
3. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics., 2022. CA Cancer J Clin. 2022;72(1):7–33. 10.3322/caac.21708
4. Lobo J, Ohashi R, Amin MB, Berney DM, Compérat EM, Cree IA, et al. WHO 2022 landscape of papillary and chromophobe renal cell carcinoma. Histopathology. 2022;81(4):426–38. 10.1111/his.14700
5. Angori S, Lobo J, Moch H. Papillary renal cell carcinoma: Current and controversial issues. Curr Opin Urol. 2022;32(4):344–51. 10.1097/MOU.0000000000001000
6. Cornejo KM, Dong F, Zhou AG, Wu CL, Young RH, Braaten K, et al. Papillary renal cell carcinoma: Correlation of tumor grade and histologic characteristics with clinical outcome. Human Pathol. 2015;46(10):1411–7. 10.1016/j.humpath.2015.07.001
7. Sukov WR, Lohse CM, Leibovich BC, Thompson RH, Cheville JC. Clinical and pathological features associated with prognosis in patients with papillary renal cell carcinoma. J Urol. 2012;187(1):54–9. 10.1016/j.juro.2011.09.053
8. Akhtar M, Al-Bozom IA, Al Hussain T. Papillary renal cell carcinoma (PRCC): An update. Adv Anat Pathol. 2019;26(2):124–32. 10.1097/PAP.0000000000000220
9. Skinner DG, Colvin RB, Vermillion CD, Pfister RC, Leadbetter WF. Diagnosis and management of renal cell carcinoma. A clinical and pathologic study of 309 cases. Cancer. 1971;28(5):1165–77. 10.1002/1097-0142(1971)28:53.0.co;2-g
10. Abou Elkassem AM, Lo SS, Gunn AJ, Shuch BM, Dewitt-Foy ME, Abouassaly R, et al. Role of imaging in renal cell carcinoma: A multidisciplinary perspective. Radiographics. 2021;41(5):1387–407. 10.1148/rg.2021200202
11. Chiarello MA, Mali RD, Kang SK. Diagnostic accuracy of MRI for detection of papillary renal cell carcinoma: A systematic and meta-analysis. AJR Am J Roentgenol. 2018;211(4), 812–21. 10.2214/AJR.17.19462
12. Srinivasan R, Hammerich K. Papillary renal cell carcinoma. In: Malouf G, Tannir N, editors. Rare kidney tumors. Cham: Springer; 2019. pp. 53–63.
13. Murugan P, Jia L, Dinatale RG, Assel M, Benfante N, Al-Ahmadie HA, et al. Papillary renal cell carcinoma: A single institutional study of 199 cases addressing classification, clinicopathologic and molecular features, and treatment outcome. Mod Pathol. 2022;35(6):825–35. 10.1038/s41379-021-00990-9
14. Patel HD, Pierorazio PM, Johnson MH, Sharma R, Iyoha E, Allaf ME, et al. Renal functional outcomes after surgery, ablation, and active surveillance of localized renal tumors: A systematic review and meta-analysis. Clin J Am Soc Nephrol. 2017;12(7):1057–69. 10.2215/CJN.11941116
15. Van Poppel H, Da Pozzo L, Albrecht W, Matveev V, Bono A, Borkowski A, et al. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2011;59(4):543–52. 10.1016/j.eururo.2010.12.013
16. Vera-Badillo FE, Templeton AJ, Duran I, Ocana A, de Gouveia P, Aneja P, et al. Systemic therapy for non-clear cell renal cell carcinomas: A systematic review and meta-analysis. Eur Urol. 2015;67(4), 740–9. 10.1016/j.eururo.2014.05.010
17. Choueiri TK, Heng DYC, Lee JL, Cancel M, Verheijen RB, Mellemgaard A, et al. Efficacy of Savolitinib vs sunitinib in patients with MET-driven papillary renal cell carcinoma: The SAVOIR phase 3 randomized clinical trial. JAMA Oncol. 2020;6(8):1247–55. 10.1001/jamaoncol.2020.2218
18. de Vries-Brilland M, McDermott DF, Suárez C, Powles T, Gross-Goupil M, Ravaud A, et al. Checkpoint inhibitors in metastatic papillary renal cell carcinoma. Cancer Treat Rev. 2022;99:102228. 10.1016/j.ctrv.2021.102228
19. Martínez Chanzá N, Xie W, Asim Bilen M, Dzimitrowicz H, Burkart J, Geynisman DM, et al. Cabozantinib in advanced non-clear-cell renal cell carcinoma: A multicentre, retrospective, cohort study. Lancet Oncol. 2019;20(4):581–90. 10.1016/S1470-2045(18)30907-0
20. Pal SK, Tangen C, Thompson IM Jr, Balzer-Haas N, George DJ, Heng DYC, et al. A comparison of sunitinib with cabozantinib, crizotinib, and savolitinib for treatment of advanced papillary renal cell carcinoma: A randomised, open-label, phase 2 trial. Lancet. 2021;397(10275):695–703. 10.1016/S0140-6736(21)00152-5
21. Escudier B, Molinie V, Bracarda S, Maroto P, Szczylik C, Nathan P, et al. Open-label phase 2 trial of first-line everolimus monotherapy in patients with papillary metastatic renal cell carcinoma: RAPTOR final analysis. Eur J Cancer. 2016;69:226–35. 10.1016/j.ejca.2016.08.004
22. Hudes G, Carducci M, Tomczak P, Dutcher J, Figlin R, Kapoor A, et al. Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med. 2016;356(22):2271–81. 10.1056/NEJMoa066838
23. Dutcher JP, de Souza P, McDermott D, Figlin RA, Berkenblit A, Thiele A, et al. Effect of temsirolimus versus interferon-alpha on outcome of patients with advanced renal cell carcinoma of different tumor histologies. Med Oncol. 2009;26(2):202–9. 10.1007/s12032-009-9177-0
24. Klatte T, Pantuck AJ, Said JW, Seligson DB, Rao NP, LaRochelle JC, et al. Cytogenetic and molecular tumor profiling for type 1 and type 2 papillary renal cell carcinoma. Clin Cancer Res. 2009;15(4):1162–9. 10.1158/1078-0432.CCR-08-1229
25. Cancer Genome Atlas Research Network, Linehan WM, Spellman PT, Ricketts CJ, Creighton CJ, Fei SS, et al. Comprehensive molecular characterization of papillary renal-cell carcinoma. N Engl J Med. 2016;374(2):135–45. 10.1056/NEJMoa1505917
26. Ledezma RA, Negron E, Paner GP, Rjepaj C, Lascano D, Haseebuddin M, et al. Clinically localized type 1 and 2 papillary renal cell carcinomas have similar survival outcomes following surgery. World J Urol. 2016;34(5):687–93. 10.1007/s00345-015-1692-3
27. Park I, Shim YS, Go H, Hong BS, Lee JL. Long-term response of metastatic hereditary leiomyomatosis and renal cell carcinoma syndrome associated renal cell carcinoma to bevacizumab plus erlotinib after temsirolimus and axitinib treatment failures. BMC Urol. 2019;19(1):51. 10.1186/s12894-019-0484-2
28. Choi Y., Keam B., Kim M., Yoon S., Kim D., Choi J. G., et al. Bevacizumab plus Erlotinib combination therapy for advanced hereditary leiomyomatosis and renal cell carcinoma-associated renal cell carcinoma: A multicenter retrospective analysis in Korean patients. Cancer Res Treat. 2019;51(4):1549–56. 10.4143/crt.2019.086
29. Schrader AJ, Rauer-Bruening S, Olbert PJ, Hegele A, Rustemeier J, Timmesfeld N, et al. Incidence and long-term prognosis of papillary renal cell carcinoma. J Cancer Res Clin Oncol. 2009;135(6):799–805. 10.1007/s00432-008-0515-y
30. Ronnen EA, Kondagunta GV, Ishill N, Spodek L, Russo P, Reuter V, et al. Treatment outcome for metastatic papillary renal cell carcinoma patients. Cancer. 2006;107(11):2617–21. 10.1002/cncr.22340
31. Pan H, Ye L, Zhu Q, Yang Z, Hu M. The effect of the papillary renal cell carcinoma subtype on oncological outcomes. Sci Rep. 2020;10:21073. 10.1038/s41598-020-78174-9
32. Cancer Genome Atlas Research Network. Comprehensive molecular profiling of lung adenocarcinoma. Nature. 2014;511(7511):543–50. 10.1038/nature13385
33. Wolf J, Seto T, Han JY, Reguart N, Garon EB, Groen HJM, et al. Capmatinib in MET exon 14-mutated or MET-amplified non-small-cell lung cancer. N Engl J Med. 2020;383(10):944–57. 10.1056/NEJMoa2002787
34. Camidge DR, Otterson GA, Clark JW, Ignatius Ou SH, Weiss J, Ades S, et al. Crizotinib in patients with MET-amplified NSCLC. J Thorac Oncol. 2021;16(6):1017–29. 10.1016/j.jtho.2021.02.010
35. Choueiri TK, Heng DYC, Lee JL, Cancel M, Verheijen RB, Mellemgaard A, et al. Efficacy of savolitinib vs sunitinib in patients with MET-driven papillary renal cell carcinoma: The SAVOIR Phase 3 randomized clinical Trial. JAMA Oncol. 2020;6(8):1247–55. 10.1001/jamaoncol.2020.2218
36. Yang XJ, Tan MH, Kim HL, Ditlev JA, Betten MW, Png CE, et al. A molecular classification of papillary renal cell carcinoma. Cancer Res. 2020;65(13):5628–37. 10.1158/0008-5472.CAN-05-0533
37. Srivastava A, Doppalapudi SK, Patel HV, Srinivasan R, Singer EA. The roaring 2020s: A new decade of systemic therapy for renal cell carcinoma. Curr Opin Oncol. 2022;34(3):234–42. 10.1097/CCO.0000000000000831
38. Ronnen EA, Kondagunta GV, Ishill N, Spodek L, Russo P, Reuter V, et al. Treatment outcome for metastatic papillary renal cell carcinoma patients. Cancer. 2006;107(11):2617–21. 10.1002/cncr.22340
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Dec 26, 2023
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Papillary Renal Cell Carcinoma: Demographics, Survival Analysis, Racial Disparities, and Genomic Landscape. (2023). Journal of Kidney Cancer, 10(4), 33-42. https://doi.org/10.15586/jkcvhl.v10i4.294
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Kidney Cancer: Original Articles
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How to Cite
Papillary Renal Cell Carcinoma: Demographics, Survival Analysis, Racial Disparities, and Genomic Landscape. (2023). Journal of Kidney Cancer, 10(4), 33-42. https://doi.org/10.15586/jkcvhl.v10i4.294