Trends and Outcomes in Sarcomatoid Renal Cell Carcinoma: Analysis of the National Cancer Data Base

There is stage migration in sarcomatoid renal cell carcinoma (sRCC), with an increase in the proportion of stage I sRCC cases from 2010 to 2019. In locally resected sRCC, partial nephrectomy with negative margins was associated with better all-cause mortality (ACM) in comparison to radical nephrecto...

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Published in:European urology open science (Online) 2025-01, Vol.71, p.96-105
Main Authors: Wang, Luke L., Puri, Dhruv, Saitta, Cesare, Liu, Franklin, Afari, Jonathan A., Meagher, Margaret F., Hakimi, Kevin, Nguyen, Mimi V., Shah, Aastha, Ghassemzadeh, Saeed, Murphy, James D., Javier-Desloges, Juan, McKay, Rana R., Derweesh, Ithaar H.
Format: Article
Language:English
Subjects:
National Cancer Data Base
Nephrectomy
Outcomes
Partial nephrectomy
Renal cell carcinoma
Sarcomatoid dedifferentiation
Stage migration
Survival
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Summary:There is stage migration in sarcomatoid renal cell carcinoma (sRCC), with an increase in the proportion of stage I sRCC cases from 2010 to 2019. In locally resected sRCC, partial nephrectomy with negative margins was associated with better all-cause mortality (ACM) in comparison to radical nephrectomy. In metastatic sRCC, cytoreductive surgery was associated with better ACM in comparison to no cytoreductive surgery. Prospective studies are needed to investigate this possible relationship and the biological mechanisms driving sarcomatoid dedifferentiation in RCC. Our aim was to determine the clinical characteristics, temporal trends, and survival outcomes for sarcomatoid-dedifferentiated renal cell carcinoma (sRCC), as sRCC has historically had poor prognosis and a contemporary cohort has not been well characterized in a population-based study. Data for 302 630 RCC cases from 2010 to 2019 were extracted from the National Cancer Data Base, of which 4.1% (12 329) were sRCC. Trend analyses were conducted using the Cochran-Armitage test. Multivariable analyses were used to assess factors associated with sRCC diagnosis and clinicopathologic characteristics associated with all-cause mortality (ACM). Overall survival (OS) was computed via Kaplan-Meier analysis. sRCC incidence increased from 3.9% in 2010 to 4.1% in 2019 (p = 0.020). The incidence of stage I sRCC increased from 14.5% in 2010 to 19.2% in 2019 (p 
ISSN:2666-1683
2666-1683
DOI:10.1016/j.euros.2024.10.002