ABSTRACT
Objective The aim of this study is to summarize the clinicopathologic characters and factors associated with prognosis of papillary renal cell carcinoma.Methods We treated 72 papillary renal cell carcinoma by surgery from August 2001 to February 2013,which account for 7.2％ of all renal cancer patients (72/1005 cases).There were 60 male and 12 female patients included in this study,with a median age of 50 (ranging from 21-75).The median tumor diameter was 5.8cm (ranging from 4 to 8cm).Fifth-two patients were asymptomatic,14 patients presented with hematuria and 6 presented with backache.In the 72 patients,63 received (87.5％) open surgery and 9 cases (12.5％) underwent laparoscopic surgery.Fortyeight patients (66.7％) were treated with radical nephrectomy and 24 patients (33.3％) were treated with partial nephrectomy.In the current study,we summarized the clinical and pathological records and follow-up data.Cox regression analysis were performed to identify the independent predictors for cancer specific survival.Results Local lymph nodes were involved in 16 cases and distal metastasis was found in 2 cases.There were 11 cases (15.3％) of type Ⅰ papillary renal cell carcinoma and 61 cases (84.7％)of type Ⅱ.All type Ⅰ cases were determined as Fuhrman grade Ⅰ and all type Ⅱ tumor were determined as Fuhrman grade Ⅱ-Ⅳ,including grade Ⅱ in 36 cases,grade Ⅲ in 15 cases and grade Ⅳ in 30 cases.With a median follow-up duration of 35 months (ranging from 7 to 146 months),10 patients died due to renal cancer,1 died due to heart failure and the rest 61 was alive.The cancer specific survival at five years for the whole group was 78.6％ (100.0％ in type Ⅰ and 75.5％ in type Ⅱ).The 5 year cancer specific survival rate for patients with Fuhrman grade Ⅰ-Ⅳ was 100.0％,83.5％,78.8％ and 31.3％,respectively.Cox regression analysis revealed that tumor diameter (hazard ratio 1.141,P =0.019) and Fuhrman grade (hazard ratio 3.034,P =0.004) were independent prognostic factors for cancer specific survival.Conclusions Type Ⅱ papillary renal cell carcinoma has more aggressive characters and poorer prognosis compared with type Ⅰ.Tumor diameter and Fuhrman grade were independent prognostic factors for cancer specific survival.