Background and objective: The effect of variant histology in renal cell carcinoma (vhRCC) on survival relative to age- and sex-matched population-based controls is unknown. This study aims to analyze the life expectancy of vhRCC patients. Methods: In the Surveillance, Epidemiology and End Results (SEER) database (2004–2016), we identified 2928 patients with vhRCC, including mesenchymal, collecting duct, medullary, mucinous, and neuroendocrine RCC, as well as RCC of sarcomatoid and rhabdoid differentiation. Kaplan-Meier plots addressed overall survival relative to simulated life expectancy in population-based controls (Monte Carlo simulation), were derived from the Social Security Administration life tables. Key findings and limitations: Of the 2928 vhRCC patients, 1905 (65%) harbored sarcomatoid, 404 (14%) mesenchymal, 318 (11%) collecting duct, 94 (3%) rhabdoid, 80 (3%) medullary, 68 (2%) mucinous, and 59 (2%) neuroendocrine RCC. Most vhRCC subtypes exhibit regional or metastatic stage at diagnosis, except for mucinous RCC. When diagnosed in metastatic stage, all vhRCC subtypes exhibited a decrease in survival rate ranging from –75% to –98% between controls and cases, except for mucinous and neuroendocrine RCC, with the least decrease in survival rate of –62% and –59%, respectively. In regional stage, all vhRCC subtypes exhibited a decrease in survival rate ranging from –68% to –41% between controls and cases, except for neuroendocrine RCC, with the least decrease in survival rate of –27%. Finally, in localized stage, all vhRCC subtypes exhibited a decrease in survival rate ranging from –56% to –22% between controls and cases, except for rhabdoid and mucinous RCC, with the least decrease in survival rate of –11% and –6%, respectively. Conclusions and clinical implications: Most vhRCC subtypes reduce survival drastically relative to life expectancy of population-based controls, except for localized rhabdoid and mucinous RCC. Especially, medullary RCC leads to distinct reductions in life expectancy, irrespective of the stage at presentation.
Life Expectancy of Renal Cell Carcinoma with Variant Histology / Le, Quynh Chi; Marmiroli, Andrea; Longoni, Mattia; Falkenbach, Fabian; Catanzaro, Calogero; Nicolazzini, Michele; Polverino, Federico; Goyal, Jordan A.; Saad, Fred; Schiavina, Riccardo; Carmignani, Luca Fabio; Briganti, Alberto; Longo, Nicola; Graefen, Markus; Palumbo, Carlotta; Wenzel, Mike; Humke, Clara; Kosiba, Marina; Chun, Felix K. -H.; Karakiewicz, Pierre I.. - In: EUROPEAN UROLOGY FOCUS. - ISSN 2405-4569. - (2025). [10.1016/j.euf.2025.05.023]
Life Expectancy of Renal Cell Carcinoma with Variant Histology
Polverino, Federico;Longo, Nicola;
2025
Abstract
Background and objective: The effect of variant histology in renal cell carcinoma (vhRCC) on survival relative to age- and sex-matched population-based controls is unknown. This study aims to analyze the life expectancy of vhRCC patients. Methods: In the Surveillance, Epidemiology and End Results (SEER) database (2004–2016), we identified 2928 patients with vhRCC, including mesenchymal, collecting duct, medullary, mucinous, and neuroendocrine RCC, as well as RCC of sarcomatoid and rhabdoid differentiation. Kaplan-Meier plots addressed overall survival relative to simulated life expectancy in population-based controls (Monte Carlo simulation), were derived from the Social Security Administration life tables. Key findings and limitations: Of the 2928 vhRCC patients, 1905 (65%) harbored sarcomatoid, 404 (14%) mesenchymal, 318 (11%) collecting duct, 94 (3%) rhabdoid, 80 (3%) medullary, 68 (2%) mucinous, and 59 (2%) neuroendocrine RCC. Most vhRCC subtypes exhibit regional or metastatic stage at diagnosis, except for mucinous RCC. When diagnosed in metastatic stage, all vhRCC subtypes exhibited a decrease in survival rate ranging from –75% to –98% between controls and cases, except for mucinous and neuroendocrine RCC, with the least decrease in survival rate of –62% and –59%, respectively. In regional stage, all vhRCC subtypes exhibited a decrease in survival rate ranging from –68% to –41% between controls and cases, except for neuroendocrine RCC, with the least decrease in survival rate of –27%. Finally, in localized stage, all vhRCC subtypes exhibited a decrease in survival rate ranging from –56% to –22% between controls and cases, except for rhabdoid and mucinous RCC, with the least decrease in survival rate of –11% and –6%, respectively. Conclusions and clinical implications: Most vhRCC subtypes reduce survival drastically relative to life expectancy of population-based controls, except for localized rhabdoid and mucinous RCC. Especially, medullary RCC leads to distinct reductions in life expectancy, irrespective of the stage at presentation.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
