Abstract
Background
Sarcomatoid differentiation in patients diagnosed with renal cell carcinoma (sRCC)
imply aggressive behavior and often metastatic disease at the time of diagnosis. We
aim to examine the overall survival (OS) in patients with sRCC using the National
Cancer Database (NCDB).
Materials and Methods
We identified patients diagnosed with sRCC between 2010-2015. We employed Kaplan-Meier
curves and multivariable Cox proportional hazards regression models to examine the
impact of several potential risk factors on OS in patients diagnosed with sRCC.
Results
In total, 8582 patients with renal cancer were found to have sarcomatoid differentiation,
with 4105 patients (47.8%) being diagnosed with AJCC stage IV disease. The median
OS was 17.2 months (IQR 5.4, 68.7 months). Compared to patients who did not undergo
surgery, OS was significantly longer in patients undergoing partial or total nephrectomy
across all stages. This result remained consistent on multivariable Cox proportional
hazards regression adjusting for patient and tumor characteristics (Surgery: Hazard
ratio 0.54, 95%Confidence interval 0.43 - 0.68, P < .001).
Conclusion
In our cohort sRCC was found to have an unfavorable median OS, which was mainly caused
by the high number of cases diagnosed with late-stage disease. Additionally, surgery
was associated with favorable OS across all stages. This study supports the notion
that surgical therapy, even in the setting of cytoreductive surgery, provides a survival
benefit in patients with sRCC.
Keywords
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Article info
Publication history
Published online: November 23, 2022
Accepted:
November 20,
2022
Received in revised form:
November 20,
2022
Received:
October 8,
2022
Identification
Copyright
© 2022 Published by Elsevier Inc.
