Abstract
Objective
To report on the long-term oncologic outcomes of 3 subtypes of low grade cystic renal
epithelial neoplasms—multilocular cystic neoplasm of low malignant potential (MCLMP),
cystic clear cell RCC (ccRCC), and cystic clear cell papillary RCC (ccpRCC), following
2016 reorganization by the World Health Organization.
Materials and Methods
A total of 3865 patients underwent radical or partial nephrectomy for unilateral,
sporadic ccRCC between 1970 and 2010, of which 145 had previously been classified
as cystic ccRCC. One genitourinary pathologist, blinded to outcome, rereviewed and
reclassified the specimens by 2016 WHO criteria. Oncologic outcomes were estimated
using the Kaplan-Meier method.
Results
Of 145 specimens, 18 (12%) were classified as MCLMP, 95 (66%) cystic ccRCC, and 32
(22%) cystic ccpRCC. Those with MCLMP were more likely female (61% vs 29% vs 31%,
P = .03) with larger tumors (median 4.6 cm vs 3.0 cm vs 2.3 cm, P = .02) compared to those with cystic ccRCC and cystic ccpRCC, respectively. Only 2%
of cystic ccRCC had tumor necrosis or grade 3 nucleoli present. Median follow-up for
survivors was 10.3 years (interquartile range 7.4-14.9). Overall, 1 MCLMP, 5 cystic
ccRCC, and 4 ccpRCC recurred during follow-up. Ten- and 20-year cancer-specific survival
was 100% across all subtypes.
Conclusion
In a large cohort of patients previously classified as cystic ccRCC with pathologic
rereview and long-term follow-up, we noted that MCLMP is the least common subtype
of low grade cystic renal epithelial neoplasms. Regardless, all subtypes are associated
with an excellent long-term prognosis following surgical resection.
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Article info
Publication history
Published online: July 26, 2019
Accepted:
July 18,
2019
Received:
May 16,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
