Does WHO/ISUP grade IV histology provide prognostic insight in chromophobe renal cell carcinoma?
INTERNATIONAL UROLOGY AND NEPHROLOGY, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11255-026-05250-w
- Dergi Adı: INTERNATIONAL UROLOGY AND NEPHROLOGY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- İstanbul Üniversitesi Adresli: Evet
Özet
Objective Chromophobe renal cell carcinoma (chRCC) is generally considered a less aggressive renal malignancy, yet a clinically meaningful subset displays adverse outcomes. We evaluated the prognostic impact of WHO/ISUP Grade IV histology on cancer-specific survival (CSS) in a large population-based, propensity score-matched cohort. Methods The SEER database (2000-2021) was queried for patients with chRCC. Patients were stratified according to WHO/ISUP grade into Grade IV chRCC and Grade I-III chRCC. The primary endpoint was CSS. A 2:1 nearest-neighbor PSM was performed using age, sex, race, AJCC stage, and tumor size. Fine-Gray competing-risk regression was performed in both the overall and propensity score-matched cohorts. Results A total of 6243 patients with chRCC were identified, including 394 (6.3%) with Grade IV histology. In the overall cohort, Grade IV chRCC was independently associated with worse CSS (HR 2.38, 95%CI 1.78-3.18, p < 0.001). After PSM (n = 1107), this association persisted (HR 1.96, 95%CI 1.43-2.69, p < 0.001) and was supported by competing-risk analysis in both the overall cohort (sHR 2.07, 95% CI 1.53-2.79, p < 0.001) and the matched cohort (sHR 1.80, 95%CI 1.32-2.46, p < 0.001). Conclusion In this large, propensity score-matched, population-based cohort, WHO/ISUP Grade IV chRCC was independently associated with poorer CSS, even after adjustment for tumor burden and stage. These findings should be interpreted within the limitations of registry-defined Grade IV classification.