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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Incesu, RB; Morra, S; Scheipner, L; Baudo, A; Cano, Garcia, C; Barletta, F; Assad, A; Tian, Z; Saad, F; Shariat, SF; Briganti, A; Chun, FKH; Carmignani, L; Ahyai, S; Longo, N; Tilki, D; Graefen, M; Karakiewicz, PI.
Sarcomatoid Dedifferentiation as a Predictor of Cancer-Specific Mortality in Surgically Treated Localized Renal Cell Carcinoma.
Ann Surg Oncol. 2024; 31(8):5457-5464
Doi: 10.1245/s10434-024-15431-5
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- Co-authors Med Uni Graz
- Ahyai Sascha
- Scheipner Lukas
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- Abstract:
- BACKGROUND: In contemporary surgically treated patients with localized high-grade (G3 or G4) clear-cell renal cell carcinoma (ccRCC), it is not known whether presence of sarcomatoid dedifferentiation is an independent predictor and/or an effect modifier, when cancer-specific mortality (CSM) represents an endpoint. METHODS: Within the Surveillance, Epidemiology, and End Results database, all surgically treated localized high-grade ccRCC patients treated between 2010 and 2020 were identified. Univariable and multivariable Cox-regression models were used. RESULTS: In 18,853 surgically treated localized high-grade (G3 or G4) ccRCC patients, 5-year CSM-free survival was 87% (62% vs. 88% with vs. without sarcomatoid dedifferentiation, p < 0.001). Presence of sarcomatoid dedifferentiation was an independent predictor of higher CSM (hazard ratio [HR] 1.8, p < 0.001). In univariable survival analyses predicting CSM, presence versus absence of sarcomatoid dedifferentiation in G3 versus G4 yielded the following hazard ratios: HR 1.0 in absent sarcomatoid dedifferentiation in G3; HR 2.7 (p < 0.001) in absent sarcomatoid dedifferentiation in G4; HR 3.9 (p < 0.001) in present sarcomatoid dedifferentiation in G3; HR 5.1 (p < 0.001) in present sarcomatoid dedifferentiation in G4. Finally, in multivariable Cox-regression analyses, the interaction terms defining present versus absent sarcomatoid dedifferentiation in G3 versus G4 represented independent predictors of higher CSM. CONCLUSIONS: In contemporary surgically treated patients with localized high-grade ccRCC, sarcomatoid dedifferentiation is not only an independent multivariable predictor of higher CSM, but also interacts with tumor grade and results in even better ability to predict CSM.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Carcinoma, Renal Cell - surgery, pathology, mortality
- Male - administration & dosage
- Female - administration & dosage
- Kidney Neoplasms - surgery, pathology, mortality
- Survival Rate - administration & dosage
- Cell Dedifferentiation - administration & dosage
- Aged - administration & dosage
- Middle Aged - administration & dosage
- Prognosis - administration & dosage
- Follow-Up Studies - administration & dosage
- SEER Program - administration & dosage
- Nephrectomy - mortality
- Neoplasm Grading - administration & dosage
- Find related publications in this database (Keywords)
- Sarcomatoid dedifferentiation
- Renal cell carcinoma
- Tumor grade
- Cancer-specific mortality