A non-diploid DNA status is linked to poor prognosis in renal cell cancer

World J Urol. 2021 Mar;39(3):829-837. doi: 10.1007/s00345-020-03226-8. Epub 2020 May 2.

Abstract

Purpose: DNA ploidy measurement has earlier been suggested as a potentially powerful prognostic tool in many cancer types, but the role in renal tumors is still unclear.

Methods: To clarify its prognostic impact, we analyzed the DNA content of 1320 kidney tumors, including clear cell, papillary and chromophobe renal cell carcinoma (RCC) as well as renal oncocytoma and compared these data with clinico-pathological parameters and patient prognosis.

Results: A non-diploid DNA content was seen in 37% of 1276 analyzable renal tumors with a striking predominance in chromophobe carcinoma (74.3% of 70 cases). In clear cell carcinoma, a non-diploid DNA content was significantly linked to high-grade (ISUP, Fuhrman, Thoenes; p < 0.0001 each), advanced tumor stage (p = 0.0011), distant metastasis (p < 0.0001), shortened overall survival (p = 0.0010), and earlier recurrence (p < 0.0001). In papillary carcinoma, an aberrant DNA content was significantly linked to high Fuhrman grade (p = 0.0063), distant metastasis (p = 0.0138), shortened overall survival (p = 0.0010), and earlier recurrence (p = 0.0003).

Conclusion: In summary, the results of our study identify a non-diploid DNA content as a predictor of an unfavorable prognosis in clear cell and papillary carcinoma.

Keywords: DNA ploidy; Flow cytometry; Prognosis; Renal cell cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell / chemistry*
  • Carcinoma, Renal Cell / genetics*
  • Carcinoma, Renal Cell / mortality
  • DNA, Neoplasm / analysis*
  • DNA, Neoplasm / genetics*
  • Humans
  • Kidney Neoplasms / chemistry*
  • Kidney Neoplasms / genetics*
  • Kidney Neoplasms / mortality
  • Middle Aged
  • Ploidies*
  • Prognosis
  • Retrospective Studies
  • Survival Rate

Substances

  • DNA, Neoplasm