Introduction

We assessed the impact of papillary renal cell carcinoma (RCC) on oncological outcomes after partial nephrectomy compared to clear cell RCC in patients with pathologic T1a RCC.

Methods

After excluding patients with synchronous multiple renal tumors, familial renal cell carcinoma, pathologic T1b or greater disease, and metastatic disease, 759 patients with clear cell and 84 patients with papillary RCC were included for the analysis. We compared the impacts of papillary RCC with clear cell RCC on oncologic outcomes. Median follow-up duration was 67 months.

Results

There was no differences in patient and tumor characteristics between the 2 groups except for Fuhrman grade (p=0.006). In Kaplan-Meier analysis, 5-year recurrence free survival was 98.7% in patients with clear cell RCC and 95.6% in patients with papillary RCC. However, 10-year recurrence free survival in patients with clear cell and papillary RCC was 96.1% and 73.0%, respectively (p<0.001). Median time to recurrence was 31 months in patients with clear cell RCC and 77 months in patients with papillary RCC although statistical significance was not achieved (p=0.190). In multivariate analysis, papillary RCC (HR; 5.309, p=0.001) was determined as a significant risk factor for recurrence after partial nephrectomy in pathologic T1a RCC patients in addition to tumor size (HR; 1.861, p=0.038) and Fuhrman grade (?3) (HR; 5.176, p=0.003).

Conclusions

Recurrence after partial nephrectomy was more commonly occurred in pathologic T1a papillary RCC compared to clear cell RCC. Because median time to recurrence in papillary RCC was greater than 5-year after surgery, longer follow-up is needed for patients with papillary RCC even though pathologic stage is T1a.

Funding

None