Archive ouverte HAL - Long-term oncological outcomes of cystic renal cell carcinoma according to the Bosniak classification

Long-term oncological outcomes of cystic renal cell carcinoma according to the Bosniak classification

Abstract : OBJECTIVES: To evaluate the prognostic role of the Bosniak classification on the long-term oncological outcomes of cystic renal cell carcinomas. MATERIAL AND METHOD: In a national multicentric retrospective study, we included patients treated surgically for localized cystic RCC from 2000 to 2010. Patients with a follow-up of less than 4 years, benign tumors, and ablative treatments were excluded. The primary outcome was disease-free survival. RESULTS: 152 patients met the inclusion criteria: Bosniak II (6%), III (53%), IV (41%), with a median follow-up of 61 (12-179) months. Characteristics of the population and the tumors were [median, (min-max)] age 57 (25-84) years old, tumor size 43 mm (20-280), RENAL score 7 (4-12), PADUA score 8 (5-14). Treatments were 55% partial nephrectomy, 45% radical nephrectomy, 74% open surgery, and 26% laparoscopy. In pathological report, cystic RCC were mainly of low grade (1-2, 77%) and low stage (pT1, 81%). The two main histological subtypes were conventional (56%) and papillary (23%) RCC. Staging at presentation and histological characteristics were similar between Bosniak III and IV, except for high grade which was more common in Bosniak IV (12 vs 36%, p < 0.01). The Bosniak classification was not predictive of the recurrence, as 5- and 10-year disease-free survival were similar in Bosniak III and IV (92% vs 92% and 84% vs 83%, p = 0.60). CONCLUSION: The Bosniak classification is predictive of the risk of malignancy but not of the oncological prognosis. Regardless of the initial Bosniak categories, almost all cystic RCCs were of low stage/grade and had low long-term recurrence rate.
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https://hal.archives-ouvertes.fr/hal-02180380
Contributeur : Catherine Zoppis <>
Soumis le : jeudi 11 juillet 2019 - 14:15:08
Dernière modification le : mercredi 17 juillet 2019 - 01:25:46

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R. Boissier, I. Ouzaid, F. Nouhaud, Z. Khene, C. Dariane, et al.. Long-term oncological outcomes of cystic renal cell carcinoma according to the Bosniak classification. International Urology and Nephrology, Springer Verlag, 2019, 51 (6), pp.951-958. ⟨10.1007/s11255-019-02085-6⟩. ⟨hal-02180380⟩

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