Chromophobe renal cell carcinoma (CHRCC): real-world data from a 15-year retrospective cohort

Keywords

Chromophobe - renal - cell - Carcinoma

Introduction: chRCC is a rare subtype of renal cell carcinoma (RCC) with distinctive histopathological features and generally favorable prognosis. Understanding its clinical outcomes and prognostic factors is essential for optimizing patient care.

Objective: To evaluate the clinicopathological features and outcomes of patients with localized or metastatic chRCC at an academic tertiary cancer center.

Methods: We conducted a retrospective analysis of patients with chRCC treated at a single cancer center. Survival probabilities were estimated using the Kaplan-Meier method. Prognostic factors were assessed through univariate analyses with the Cox regression model.

Results: From 2009 to 2024, 2181 patients with RCC were diagnosed, including 718 with non-clear cell histology. We analyzed 123 patients with chRCC, comprising 20 with advanced disease (metastatic at diagnosis, n = 8; relapsed, n = 12). The median age was 58 years (IQR 48.5-55.5), 56.9% were females, 69.1% had ECOG performance status 0 and 26.8% ECOG-PS 1. Tumors were staged T1-2 in 61.8% and T3-4 in 34.1%. 23% had a second malignancy, including 6 patients with a second RCC. In the advanced disease cohort, the most prevalent site of metastasis was lymph node (55%), followed by bone (45%). Systemic treatment was administered in 55% (pazopanib, n = 6; sunitinib, n = 4; sorafenib, n = 1), with a 18.2% response rate. Metastasis-directed therapy (MDT) was commonly used (65%; surgery, n = 9; radiotherapy, n = 2; multiple modalities, n = 2). The 5-year overall survival (OS) for the full cohort was 84.9% (95% CI 78.3 - 92.1%) with a median follow-up of 75.1 months. Poor survival was associated with M1 stage at diagnosis (p<0.001). In the advanced disease cohort, the 5-year OS was 21% (95% CI 7.8 - 56.3%). Improved survival was associated with MDT use (HR 0.23, 95% CI 0.07 - 0.75) and favorable International mRCC Database Consortium score (HR 0.08, 95% CI 0.01 - 0.51). For patients with localized disease, the 5-year disease-free survival (DFS) was 85.2% (95% CI 78.3 - 92.7%). In this cohort, no factors were statistically associated with relapse or death, including stage (p = 0.1), ECOG-PS (p = 0.21) or histological grade (p = 0.11).

Conclusion: chRCC is associated with good prognosis. Advanced disease associated with shorter survival and response to systemic therapy is disappointing. However, patients treated with MDT showed significantly better outcomes, although this might have occurred due to selection bias.

Corresponding author: Rogério Almeida Moreno Santos (e-mail: [e-mail]).

 

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Die Autoren geben an, dass kein Interessenkonflikt besteht.

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Artikel online veröffentlicht:
06. Mai 2025