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Mortality According to Treatment in Metastatic Collecting Duct Renal Cell Carcinoma

  • Andrea Panunzio
    Correspondence
    Address for correspondence: Andrea Panunzio, MD, Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
    Affiliations
    Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy

    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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  • Gabriele Sorce
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

    Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
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  • Stefano Tappero
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

    Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy

    Department of Urology, IRCCS Policlinico San Martino, Genova, Italy
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  • Lukas Hohenhorst
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

    Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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  • Cristina Cano Garcia
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

    Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
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  • Mattia Piccinelli
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

    Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy
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  • Zhe Tian
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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  • Alessandro Tafuri
    Affiliations
    Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
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  • Ottavio De Cobelli
    Affiliations
    Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy
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  • Felix K.H. Chun
    Affiliations
    Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
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  • Derya Tilki
    Affiliations
    Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Department of Urology, Koc University Hospital, Istanbul, Turkey
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  • Carlo Terrone
    Affiliations
    Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy

    Department of Urology, IRCCS Policlinico San Martino, Genova, Italy
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  • Alberto Briganti
    Affiliations
    Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
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  • Anil Kapoor
    Affiliations
    Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada.
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  • Fred Saad
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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  • Shahrokh F. Shariat
    Affiliations
    Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

    Departments of Urology, Weill Cornell Medical College, New York, NY

    Department of Urology, University of Texas Southwestern, Dallas, TX

    Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
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  • Maria Angela Cerruto
    Affiliations
    Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
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  • Alessandro Antonelli
    Affiliations
    Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
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  • Pierre I. Karakiewicz
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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Published:August 28, 2022DOI:https://doi.org/10.1016/j.clgc.2022.08.010

      Highlights

      • -
        Collecting duct renal cell carcinoma is an orphan disease.
      • -
        Collecting duct renal cell carcinoma often presents with advanced stage at initial diagnosis.
      • -
        Combination of cytoreductive nephrectomy and systemic therapy result in lowest mortality rates in metastatic collecting duct renal carcinoma.

      Abstract

      Introduction

      Controlled contemporary analyses of mortality in metastatic collecting duct renal cell carcinoma (mcdRCC) are unavailable. We addressed this knowledge gap and tested rates of treatment and associated mortality in patients with mcdRCC.

      Patients and Methods

      Within Surveillance, Epidemiology, and End Results database (2004-2018), we identified 155 mcdRCC patients. Kaplan-Meier plots and Cox proportional hazards regression models tested the effect of treatment (cytoreductive nephrectomy [CN] alone vs. systemic therapy [ST] alone vs. combination of both CN + ST) on overall mortality (OM).

      Results

      In the overall cohort (n = 155), 57 patients (37%) were treated with combination of both CN + ST, 46 (30%) underwent CN alone, 28 (18%) received ST alone, and 24 (15%) had none/unknown treatment. According to age categories (≤ 59 vs. 60-69 vs. ≥ 70 years), rates of combination of both CN + ST were 45% vs. 45% vs. 14%, respectively. CN alone was the most frequent type of treatment in patients aged ≥ 70 (50%). Median overall survival was 4.0 months for CN alone vs. 5.5 months for ST alone vs. 9.0 months for combination of both CN+ST. In multivariable Cox regression models, where CN alone was the referent, the use of ST alone and combination of both CN + ST were respectively associated with a HR of 0.74 (P = .3) and 0.43 (P < .001), after adjustment for all covariates.

      Conclusions

      In mcdRCC patients, concomitant use of CN and ST results in lowest mortality, followed by ST alone, and CN alone. In consequence combination of both CN + ST should be recommended whenever applicable.

      Keywords

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