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Grading Challenges and Prognostic Insights in Chromophobe Renal Cell Carcinoma: A Retrospective Study of 72 Patients.
Papanikolaou, Dimitrios; Sokolakis, Ioannis; Moysidis, Kyriakos; Pyrgidis, Nikolaos; Bobos, Mattheos; Meditskou, Soultana; Hatzimouratidis, Konstantinos.
Affiliation
  • Papanikolaou D; Second Department of Urology, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
  • Sokolakis I; Second Department of Urology, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
  • Moysidis K; Second Department of Urology, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
  • Pyrgidis N; Department of Urology, University Hospital, LMU Munich, 80539 Munich, Germany.
  • Bobos M; Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 570 01 Thessaloniki, Greece.
  • Meditskou S; Laboratory of Histology and Embryology, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
  • Hatzimouratidis K; Second Department of Urology, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Medicina (Kaunas) ; 60(6)2024 Jun 18.
Article in En | MEDLINE | ID: mdl-38929613
ABSTRACT
Chromophobe RCC (ChRCC) carries the best prognosis among all RCC subtypes, yet it lacks a proper grading system. Various systems have been suggested in the past, causing much controversy, and Avulova et al. recently proposed a promising four-tier grading system that takes into consideration tumor necrosis. Dysregulation of the mammalian target of the rapamycin (mTOR) pathway plays a key role in ChRCC pathogenesis, highlighting its molecular complexity. The present retrospective study aimed to evaluate the prognostic factors associated with a more aggressive ChRCC phenotype. Materials and

Methods:

Seventy-two patients diagnosed with ChRCC between 2004 and 2017 were included in our study. Pathology reports and tissue blocks were reviewed, and immunohistochemistry (IHC) was performed in order to assess the expressions of CYLD (tumor-suppressor gene) and mTOR, among other markers. Univariate analysis was performed, and OS was assessed using the Kaplan-Meier method.

Results:

In our study, 74% of patients were male, with a mean age of 60 years, and the mean tumor size was 63 mm (±44). The majority (54%) were followed for more than 10 years at intervals ranging between 44 and 222 months. The risk of death was significantly higher for patients that were classified as Grade 4 in the Avulova system (HR 5.83; 95% CI, 1.37-24.7; p = 0.017). As far as the IHC is concerned, mTOR expression was associated with an HR of 8.57 (95% CI, 1.91-38.5; p = 0.005), and CYLD expression was associated with an HR of 17.3 (95% CI, 1.57-192; p = 0.02).

Conclusions:

In our study, the Avulova grading system seems to be positively correlated with OS in patients diagnosed with ChRCC. Furthermore, an elevated mTOR expression also shows a negative correlation with OS, whereas an elevated CYLD expression does not seem to exert a protective role. However, because only a small proportion (4.2%) of our patients died due to ChRCC, despite the long follow-up period, the results must be interpreted with caution. Further research is needed to validate our findings.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Carcinoma, Renal Cell / TOR Serine-Threonine Kinases / Neoplasm Grading / Kidney Neoplasms Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Medicina (Kaunas) Journal subject: MEDICINA Year: 2024 Document type: Article Affiliation country: Publication country: CH / SUIZA / SUÍÇA / SWITZERLAND

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Carcinoma, Renal Cell / TOR Serine-Threonine Kinases / Neoplasm Grading / Kidney Neoplasms Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Medicina (Kaunas) Journal subject: MEDICINA Year: 2024 Document type: Article Affiliation country: Publication country: CH / SUIZA / SUÍÇA / SWITZERLAND