4.4 Article

Collecting duct carcinoma: A single-institution retrospective study

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.urolonc.2021.09.019

Keywords

Collecting duct carcinoma; Non-clear cell renal cell carcinoma

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Collecting duct carcinoma is a rare type of kidney cancer that mainly affects males with a median age of 57 years old. Most patients present with high-grade disease at the time of nephrectomy, and early local recurrence and distant metastases are common. However, some patients with small tumors may benefit from nephrectomy in the long term.
Purpose: Collecting duct carcinoma is a rare pathologic entity with a paucity of clinical data in the literature. We aim to evaluate our institutional experience with the management of this disease. Materials and methods: All renal tumors in the Mayo Clinic Nephrectomy Registry were re-reviewed retrospectively by an expert urologic pathologist. Cases of collecting duct carcinoma were identified. Descriptive statistics were used to characterize these cases. Overall survival and metastases-free survival were estimated using Kaplan-Meier methodology. Results: Between 1970 and 2018, a total of 21 cases were identified with an incidence of 0.2%. Cases were seen predominantly in men (N = 17, 81%) with a median age at diagnosis of 57 years old. At the time of nephrectomy, high grade disease (grade 3 or 4) was noted in the majority of patients (90%). The median times to local recurrence and distant metastases were 5.6 and 5.1 months, respectively. Median overall survival occurred at 1.5 years. Median distant metastases-free survival among MO patients occurred at 0.5 years. Four patients with localized disease and small tumor size who underwent nephrectomy lived longer than 10 years. No systemic therapies achieved a durable response in the metastatic setting. Conclusion: The Mayo Clinic nephrectomy registry contains 21 patients with collecting duct carcinoma over nearly 50 years. Early local recurrence and distant metastases were seen after nephrectomy. However, MO patients with a small tumor may have long-term benefits from nephrectomy. Neither chemotherapy nor targeted therapy resulted in a durable response in the metastatic setting. (C) 2021 Elsevier Inc. All rights reserved.

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