Does chromophobe renal cell carcinoma have better survival than clear cell renal cell carcinoma? A clinical-based cohort study and meta-analysis
Jiang Hui-Ming
Wei Jin-Huan
Zhang Zhi-Ling
Fang Yong
Zhou Bang-Fen
Chen Zhen-Hua
Lu Jun
Liao Bing
Zhou Fang-Jian
Luo Jun-Hang
Chen Wei
· 2016
期刊名称:
International Urology and Nephrology
2016 年
48 卷
2 期
摘要:
Background: It is controversial whether chromophobe renal cell carcinoma (chRCC) or clear cell renal cell carcinoma (ccRCC) is associated with better survival. We conducted a clinical-based cohort study and meta-analysis to evaluate the prognostic role of histology between chRCC and ccRCC. Methods: A cohort of 1540 patients (166 with chRCC and 1374 with ccRCC) were selected from Sun Yat-sen University and The Cancer Genome Atlas databases. The clinicopathological parameters and overall survival (OS) were compared between patients with chRCC and those with ccRCC. For the meta-analysis, we searched the PubMed, Cochrane Library, and Ovid databases for studies comparing OS or cancer-specific survival (CSS) between chRCC and ccRCC. Results: The cohort study revealed that patients with chRCC were younger (median 52 vs. 55??years, P???0.001), were more commonly female (47.0 vs. 33.0??%, P???0.001), and had a larger tumor size (mean 7.1 vs. 5.9??cm, P???0.001), and they had a lower stage compared with those with ccRCC. Five-year OS rates for chRCC and ccRCC were 90.3 and 75.3??%, respectively (P???0.001). We found significantly better survival for chRCC in stratification analysis by age, sex, tumor size, and stage. Similar results were observed on both univariate [hazard ratio (HR), 0.30; 95??% confidence interval (CI) 0.16??“0.55, P???0.001] and multivariate analyses (HR 0.42; 95??% CI 0.23??“0.79, P??=??0.006). Ten studies were included in our meta-analysis. Eight of them provided data on univariate analysis. The pooled HR was statistically significant for OS (pooled HR 0.49; 95??% CI 0.30??“0.79, P??=??0.004) and CSS (pooled HR 0.49; 95??% CI 0.37??“0.64, P???0.001). Seven studies reported the HR on multivariate analysis. The pooled HR was also statistically significant for OS (pooled HR 0.63; 95??% CI 0.51??“0.77, P???0.001) and CSS (pooled HR 0.72; 95??% CI 0.57??“0.90, P??=??0.003). These data indicate that patients with chRCC had better outcomes than those with ccRCC. Conclusions: Our large cohort study and meta-analysis confirmed that chRCC had better survival than ccRCC.