Multi-institutional re-evaluation of prognostic factors in chromophobe renal cell carcinoma: proposal of a novel two-tiered grading scheme

Ohashi R, Martignoni G, Hartmann A, Caliò A, Segala D, Stöhr C, Wach S, Erlmeier F, Weichert W, Autenrieth M, Schraml P, Rupp NJ, Ohe C, Otsuki Y, Kawasaki T, Kobayashi H, Kobayashi K, Miyazaki T, Shibuya H, Usuda H, Umezu H, Fujishima F, Furusato B, Osakabe M, Sugai T, Kuroda N, Tsuzuki T, Nagashima Y, Ajioka Y, Moch H (2019)

Publication Type: Journal article

Publication year: 2019

Journal

DOI: 10.1007/s00428-019-02710-w

Abstract

A histological grading system of chromophobe renal cell carcinoma (chRCC) is highly desirable to identify approximately 5–10% of tumors at risk for progression. Validation studies failed to demonstrate a correlation between the four-tiered WHO/ISUP grade and outcome. Previous proposals with three-tiered chromophobe grading systems could not be validated. In this study, the presence of sarcomatoid differentiation, necrosis, and mitosis was analyzed in a Swiss cohort (n = 42), an Italian cohort (n = 103), a German cohort (n = 54), a Japanese cohort (n = 119), and The Cancer Genome Atlas cohort (n = 64). All 3 histological parameters were significantly associated with shorter time to tumor progression and overall survival in univariate analysis. Interobserver variability for identification of these parameters was measured by Krippendorff’s alpha coefficient and showed high concordance for the identification of sarcomatoid differentiation and tumor necrosis, but only low to medium concordance for the identification of mitosis. Therefore, we tested a two-tiered tumor grading system (low versus high grade) based only on the presence of sarcomatoid differentiation and/or necrosis finding in the combined cohorts (n = 382). pT stage, patient’s age (> 65 vs ≤ 65), lymph node and/or distant metastasis, and the two-tiered grading system (low versus high grade) were significantly associated with overall survival and were independent prognostic parameters in multivariate analysis (Cox proportional hazard). This multi-institutional evaluation of prognostic parameters suggests tumor necrosis and sarcomatoid differentiation as reproducible components of a two-tiered chromophobe tumor grading system.

Authors with CRIS profile

Involved external institutions

Niigata University / 新潟大学 Japan (JP) Klinikum rechts der Isar Germany (DE) Universitätsspital Zürich (USZ) Switzerland (CH) University of Verona / Università degli Studi di Verona Italy (IT) Gifu University / 岐阜大学 Japan (JP) Technische Universität München (TUM) Germany (DE) Kansai Medical University Japan (JP) Niigata City General Hospital Japan (JP) Tachikawa General Hospital Japan (JP) Niigata University of Pharmacy and Applied Life Sciences / 新潟薬科大学 Japan (JP) Seirei Hamamatsu General Hospital Japan (JP) Iwate Medical University Japan (JP) Aichi Medical University / 愛知医科大学 Japan (JP) Tokyo Women's Medical University Japan (JP) Japanese Red Cross Kochi Hospital Japan (JP) Tohoku University Japan (JP) Nagasaki University Japan (JP) Nagaoka Red Cross Hospital Japan (JP) Ospedale P. Pederzoli Italy (IT)

How to cite

APA:

Ohashi, R., Martignoni, G., Hartmann, A., Caliò, A., Segala, D., Stöhr, C.,... Moch, H. (2019). Multi-institutional re-evaluation of prognostic factors in chromophobe renal cell carcinoma: proposal of a novel two-tiered grading scheme. Virchows Archiv. https://doi.org/10.1007/s00428-019-02710-w

MLA:

Ohashi, Riuko, et al. "Multi-institutional re-evaluation of prognostic factors in chromophobe renal cell carcinoma: proposal of a novel two-tiered grading scheme." Virchows Archiv (2019).

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