Chromophobe Renal Cell Carcinoma with Sarcomatoid Differentiation
Main Article Content
Keywords
chromophobe renal cell carcinoma, immune checkpoint inhibitors, kidney cancer, sarcomatoid
Abstract
Chromophobe renal cell carcinoma (chRCC) is one of the less common types of kidney cancer and generally portends a more favorable prognosis. RCC with sarcomatoid differentiation has a more aggressive clinical course with poor outcomes. Four cases of chRCC with varying degrees of sarcomatoid differentiation were retrospectively reviewed at our institution, and clinicopathologic data as well as clinical courses were reported. Patients with higher degrees of sarcomatoid differentiation and larger tumors at presentation generally had and worse overall survival. chRCC with sarcomatoid differentiation portends a poor prognosis with limited data on systemic treatment options for metastatic disease.
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26. Patel HD, Puligandla M, Shuch BM, Leibovich BC, Kapoor A, Master VA, et al. The future of perioperative therapy in advanced renal cell carcinoma: How can we PROSPER? Future Oncol. 2019;15(15):1683–95. 10.2217/fon-2018-0951
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28. Chen CV, Croom NA, Simko JP, Stohr BA, Chan E. Differential immunohistochemical and molecular profiling of conventional and aggressive components of chromophobe renal cell carcinoma: Pitfalls for diagnosis. Hum Pathol. 2022;119:85–93. 10.1016/j.humpath.2021.11.003
29. Przybycin CG, Cronin AM, Darvishian F, Gopalan A, Al-Ahmadie HA, Fine SW, et al. Chromophobe renal cell carcinoma: A clinicopathologic study of 203 tumors in 200 patients with primary resection at a single institution. Am J Surg Pathol. 2011;35(7):962–70. 10.1097/PAS.0b013e31821a455d
30. Pichler R, Comperat E, Klatte T, Pichler M, Loidl W, Lusuardi L, et al. Renal cell carcinoma with sarcomatoid features: Finally, new therapeutic hope? Cancers (Basel). 2019;11(3):422. 10.3390/cancers11030422
2. Shuch B, Amin A, Armstrong AJ, Eble JN, Ficarra V, LopezBeltran A, et al. Understanding pathologic variants of renal cell carcinoma: Distilling therapeutic opportunities from biologic complexity. Eur Urol. 2015;67(1):85–97. 10.1016/j.eururo.2014.04.029
3. Cheville JC, Lohse CM, Zincke H, Weaver AL, Blute ML. Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma. Am J Surg Pathol. 2003;27(5):612–24. 10.1097/00000478-200305000-00005
4. Amin MB, Paner GP, Alvarado-Cabrero I, Young AN, Stricker HJ, Lyles RH, et al. Chromophobe renal cell carcinoma: Histomorphologic characteristics and evaluation of conventional pathologic prognostic parameters in 145 cases. Am J Surg Pathol. 2008;32(12):1822–34. 10.1097/PAS.0b013e3181831e68
5. Mouallem NE, Smith SC, Paul AK. Sarcomatoid renal cell carcinoma: Biology and treatment advances. Urol Oncol. 2018;36(6):265–71. 10.1016/j.urolonc.2017.12.012
6. Ged Y, Chen YB, Knezevic A, Casuscelli J, Redzematovic A, DiNatale RG, et al. Metastatic chromophobe renal cell carcinoma: Presence or absence of sarcomatoid differentiation determines clinical course and treatment outcomes. Clin Genitourin Cancer. 2019;17(3):e678–e88. 10.1016/j.clgc.2019.03.018
7. Cheville JC, Lohse CM, Sukov WR, Thompson RH, Leibovich BC. Chromophobe renal cell carcinoma: The impact of tumor grade on outcome. Am J Surg Pathol. 2012;36(6):851–6. 10.1097/PAS.0b013e3182496895
8. Lauer SR, Zhou M, Master VA, Osunkoya AO. Chromophobe renal cell carcinoma with sarcomatoid differentiation: A clinicopathologic study of 14 cases. Anal Quant Cytopathol Histpathol. 2013;35(2):77–84.
9. Leong S, Moss RA, Bowles DW, Ware JA, Zhou J, Spoerke JM, et al. A phase I dose-escalation study of the safety and pharmacokinetics of pictilisib in combination with erlotinib in patients with advanced solid tumors. Oncologist. 2017;22(12):1491-9. 10.1634/theoncologist.2017-0090
10. Volpe A, Novara G, Antonelli A, Bertini R, Billia M, Carmignani G, et al. Chromophobe renal cell carcinoma (RCC): Oncological outcomes and prognostic factors in a large multicentre series. BJU Int. 2012;110(1):76–83. 10.1111/j.1464-410X.2011.10690.x
11. Casuscelli J, Becerra MF, Seier K, Manley BJ, Benfante N, Redzematovic A, et al. Chromophobe renal cell carcinoma: Results from a large single-institution series. Clin Genitourin Cancer. 2019;17(5):373–9 e4. 10.1016/j.clgc.2019.06.011
12. Patel HV, Srivastava A, Srinivasan R, Singer EA. A challenging frontier—The genomics and therapeutics of nonclear cell renal cell carcinoma. Curr Opin Oncol. 2021;33(3):212–20. 10.1097/CCO.0000000000000721
13. Motzer RJ, Jonasch E, Agarwal N, Alva A, Baine M, Beckermann K, et al. Kidney cancer, version 3.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2022;20(1):71–90. 10.6004/jnccn.2022.0001
14. de Peralta-Venturina M, Moch H, Amin M, Tamboli P, Hailemariam S, Mihatsch M, et al. Sarcomatoid differentiation in renal cell carcinoma: A study of 101 cases. Am J Surg Pathol. 2001;25(3):275–84. 10.1097/00000478-200103000-00001
15. Pieretti AC, Westerman ME, Childs A, Millward N, Shapiro DD, Sircar K, et al. Sarcomatoid features and lymph node-positive disease in chromophobe renal cell carcinoma. Urol Oncol. 2021;39(11):790 e17–e23. 10.1016/j.urolonc.2021.06.016
16. Haas NB, Lin X, Manola J, Pins M, Liu G, McDermott D, et al. A phase II trial of doxorubicin and gemcitabine in renal cell carcinoma with sarcomatoid features: ECOG 8802. Med Oncol. 2012;29(2):761–7. 10.1007/s12032-011-9829-8
17. Roubaud G, Gross-Goupil M, Wallerand H, de Clermont H, Dilhuydy MS, Ravaud A. Combination of gemcitabine and doxorubicin in rapidly progressive metastatic renal cell carcinoma and/or sarcomatoid renal cell carcinoma. Oncology. 2011;80(3-4):214–8. 10.1159/000329078
18. Motzer RJ, Jonasch E, Boyle S, Carlo MI, Manley B, Agarwal N, et al. NCCN guidelines insights: Kidney cancer, Version 1.2021. J Natl Compr Canc Netw. 2020;18(9):1160–70.
19. Maiti A, Nemati-Shafaee M, Msaouel P, Pagliaro LC, Jonasch E, Tannir NM, et al. Phase 2 trial of capecitabine, gemcitabine, and bevacizumab in sarcomatoid renal-cell carcinoma. Clin Genitourin Cancer. 2017;S1558-7673(17):30238. 10.1016/j.clgc.2017.07.028
20. Moch H, Ohashi R. Chromophobe renal cell carcinoma: Current and controversial issues. Pathology. 2021;53(1):101–8. 10.1016/j.pathol.2020.09.015
21. Chahoud J, Msaouel P, Ross JA, McCormick BZ, Bathala TK, Gao J, et al. Outcomes of patients with metastatic renal cell carcinoma with sarcomatoid dedifferentiation to immune checkpoint inhibitors. Urol Oncol. 2021;39(2):134 e9–e16. 10.1016/j.urolonc.2020.10.019
22. Quhal F, Mori K, Fajkovic H, Remzi M, Shariat SF, Schmidinger M. Immunotherapy-based combinations in the first-line treatment of metastatic renal cell carcinoma with sarcomatoid features: A systematic review and network meta-_analysis. Curr Opin Urol. 2022;32(1):61–8. 10.1097/MOU.0000000000000940
23. Bakouny Z, Braun DA, Shukla SA, Pan W, Gao X, Hou Y, et al. Integrative molecular characterization of sarcomatoid and rhabdoid renal cell carcinoma. Nat Commun. 2021;12(1):808. 10.1038/s41467-021-21068-9
24. Blum KA, Gupta S, Tickoo SK, Chan TA, Russo P, Motzer RJ, et al. Sarcomatoid renal cell carcinoma: biology, natural history and management. Nat Rev Urol. 2020;17(12):659–78. 10.1038/s41585-020-00382-9
25. Wu Y, Kwon YS, Labib M, Foran DJ, Singer EA. Magnetic resonance imaging as a biomarker for renal cell carcinoma. Dis Markers. 2015;2015:648495. 10.1155/2015/648495
26. Patel HD, Puligandla M, Shuch BM, Leibovich BC, Kapoor A, Master VA, et al. The future of perioperative therapy in advanced renal cell carcinoma: How can we PROSPER? Future Oncol. 2019;15(15):1683–95. 10.2217/fon-2018-0951
27. Alaghehbandan R, Przybycin CG, Verkarre V, Mehra R. Chromophobe renal cell carcinoma: Novel molecular insights and clinicopathologic updates. Asian J Urol. 2022;9(1):1–11. 10.1016/j.ajur.2021.11.010
28. Chen CV, Croom NA, Simko JP, Stohr BA, Chan E. Differential immunohistochemical and molecular profiling of conventional and aggressive components of chromophobe renal cell carcinoma: Pitfalls for diagnosis. Hum Pathol. 2022;119:85–93. 10.1016/j.humpath.2021.11.003
29. Przybycin CG, Cronin AM, Darvishian F, Gopalan A, Al-Ahmadie HA, Fine SW, et al. Chromophobe renal cell carcinoma: A clinicopathologic study of 203 tumors in 200 patients with primary resection at a single institution. Am J Surg Pathol. 2011;35(7):962–70. 10.1097/PAS.0b013e31821a455d
30. Pichler R, Comperat E, Klatte T, Pichler M, Loidl W, Lusuardi L, et al. Renal cell carcinoma with sarcomatoid features: Finally, new therapeutic hope? Cancers (Basel). 2019;11(3):422. 10.3390/cancers11030422
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Jul 8, 2023
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How to Cite
Chromophobe Renal Cell Carcinoma with Sarcomatoid Differentiation. (2023). Journal of Kidney Cancer and VHL, 10(3), 1-8. https://doi.org/10.15586/jkcvhl.v10i3.254
Section
Kidney Cancer: Case Reports
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