Survival in patients with rare subtypes of renal cell carcinoma

<b>Objective</b> To evaluate the survival of patients with rare malignant histological subtypes of renal cancer. <p> <b>Patients and methods</b> The Heidelberg classification of renal cell carcinoma (RCC) divides tumours into clear cell carcinoma (CCC), papillary cancer (PC), chromophobic cancer (ChC) and collecting duct carcinoma (CDC). Sarcomatoid tumours are in a different subgroup treated as a final stage of histological progression. Between 1990 and 1997, 319 nephrectomies were undertaken because of RCC in 317 patients. In 42 patients (13%) the pathological findings showed other than CCC; in 13 PC was confirmed histologically, in nine ChC, in 11 a mixed type of CCC and sarcomatoid type, in seven a sarcomatoid tumour and in four, CDC. <p> <b>Results</b> One patient of the 13 with PC and two of the nine with ChC died. The worst prognosis was in those with CDC, CCC-sarcomatoid and sarcomatoid tumours, as all these patients died. <p> <b>Conclusion</b> The histopathological differentiation of RCC into subtypes gives additional useful prognostic information.