Sarcomatoid renal cell carcinoma: MRI features and their association with survival

Abstract Objective To evaluate MRI features of sarcomatoid renal cell carcinoma (RCC) and their association with survival. Methods This retrospective single-center study included 59 patients with sarcomatoid RCC who underwent MRI before nephrectomy during July 2003–December 2019. Three radiologists...

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Main Authors: Monica Cheng, Cihan Duzgol, Tae-Hyung Kim, Soleen Ghafoor, Anton S. Becker, Pamela I. Causa Andrieu, Natalie Gangai, Hui Jiang, Abraham A. Hakimi, Hebert A. Vargas, Sungmin Woo
Format: Article
Language:English
Published: BMC 2023-02-01
Series:Cancer Imaging
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Online Access:https://doi.org/10.1186/s40644-023-00535-0
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author Monica Cheng
Cihan Duzgol
Tae-Hyung Kim
Soleen Ghafoor
Anton S. Becker
Pamela I. Causa Andrieu
Natalie Gangai
Hui Jiang
Abraham A. Hakimi
Hebert A. Vargas
Sungmin Woo
author_facet Monica Cheng
Cihan Duzgol
Tae-Hyung Kim
Soleen Ghafoor
Anton S. Becker
Pamela I. Causa Andrieu
Natalie Gangai
Hui Jiang
Abraham A. Hakimi
Hebert A. Vargas
Sungmin Woo
author_sort Monica Cheng
collection DOAJ
description Abstract Objective To evaluate MRI features of sarcomatoid renal cell carcinoma (RCC) and their association with survival. Methods This retrospective single-center study included 59 patients with sarcomatoid RCC who underwent MRI before nephrectomy during July 2003–December 2019. Three radiologists reviewed MRI findings of tumor size, non-enhancing areas, lymphadenopathy, and volume (and percentage) of T2 low signal intensity areas (T2LIA). Clinicopathological factors of age, gender, ethnicity, baseline metastatic status, pathological details (subtype and extent of sarcomatoid differentiation), treatment type, and follow-up were extracted. Survival was estimated using Kaplan-Meier method and Cox proportional-hazards regression model was used to identify factors associated with survival. Results Forty-one males and eighteen females (median age 62 years; interquartile range 51–68) were included. T2LIAs were present in 43 (72.9%) patients. At univariate analysis, clinicopathological factors associated with shorter survival were: greater tumor size (> 10 cm; HR [hazard ratio] = 2.44, 95% CI 1.15–5.21; p = 0.02), metastatic lymph nodes (present; HR = 2.10, 95% CI 1.01–4.37; p = 0.04), extent of sarcomatoid differentiation (non-focal; HR = 3.30, 95% CI 1.55–7.01; p < 0.01), subtypes other than clear cell, papillary, or chromophobe (HR = 3.25, 95% CI 1.28–8.20; p = 0.01), and metastasis at baseline (HR = 5.04, 95% CI 2.40–10.59; p < 0.01). MRI features associated with shorter survival were: lymphadenopathy (HR = 2.24, 95% CI 1.16–4.71; p = 0.01) and volume of T2LIA (> 3.2 mL, HR = 4.22, 95% CI 1.92–9.29); p < 0.01). At multivariate analysis, metastatic disease (HR = 6.89, 95% CI 2.79–16.97; p < 0.01), other subtypes (HR = 9.50, 95% CI 2.81–32.13; p < 0.01), and greater volume of T2LIA (HR = 2.51, 95% CI 1.04–6.05; p = 0.04) remained independently associated with worse survival. Conclusion T2LIAs were present in approximately two thirds of sarcomatoid RCCs. Volume of T2LIA along with clinicopathological factors were associated with survival.
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spelling doaj.art-c00e9228b82f418b9d6cddad01f2697a2023-03-22T12:15:12ZengBMCCancer Imaging1470-73302023-02-0123111010.1186/s40644-023-00535-0Sarcomatoid renal cell carcinoma: MRI features and their association with survivalMonica Cheng0Cihan Duzgol1Tae-Hyung Kim2Soleen Ghafoor3Anton S. Becker4Pamela I. Causa Andrieu5Natalie Gangai6Hui Jiang7Abraham A. Hakimi8Hebert A. Vargas9Sungmin Woo10Department of Radiology, Memorial Sloan Kettering Cancer CenterDepartment of Radiology, Memorial Sloan Kettering Cancer CenterDepartment of Radiology, Memorial Sloan Kettering Cancer CenterInstitute of Diagnostic and Interventional Radiology, University Hospital ZurichDepartment of Radiology, Memorial Sloan Kettering Cancer CenterDepartment of Radiology, Memorial Sloan Kettering Cancer CenterDepartment of Radiology, Memorial Sloan Kettering Cancer CenterUrology Service, Department of Surgery, Memorial Sloan Kettering Cancer CenterUrology Service, Department of Surgery, Memorial Sloan Kettering Cancer CenterDepartment of Radiology, Memorial Sloan Kettering Cancer CenterDepartment of Radiology, Memorial Sloan Kettering Cancer CenterAbstract Objective To evaluate MRI features of sarcomatoid renal cell carcinoma (RCC) and their association with survival. Methods This retrospective single-center study included 59 patients with sarcomatoid RCC who underwent MRI before nephrectomy during July 2003–December 2019. Three radiologists reviewed MRI findings of tumor size, non-enhancing areas, lymphadenopathy, and volume (and percentage) of T2 low signal intensity areas (T2LIA). Clinicopathological factors of age, gender, ethnicity, baseline metastatic status, pathological details (subtype and extent of sarcomatoid differentiation), treatment type, and follow-up were extracted. Survival was estimated using Kaplan-Meier method and Cox proportional-hazards regression model was used to identify factors associated with survival. Results Forty-one males and eighteen females (median age 62 years; interquartile range 51–68) were included. T2LIAs were present in 43 (72.9%) patients. At univariate analysis, clinicopathological factors associated with shorter survival were: greater tumor size (> 10 cm; HR [hazard ratio] = 2.44, 95% CI 1.15–5.21; p = 0.02), metastatic lymph nodes (present; HR = 2.10, 95% CI 1.01–4.37; p = 0.04), extent of sarcomatoid differentiation (non-focal; HR = 3.30, 95% CI 1.55–7.01; p < 0.01), subtypes other than clear cell, papillary, or chromophobe (HR = 3.25, 95% CI 1.28–8.20; p = 0.01), and metastasis at baseline (HR = 5.04, 95% CI 2.40–10.59; p < 0.01). MRI features associated with shorter survival were: lymphadenopathy (HR = 2.24, 95% CI 1.16–4.71; p = 0.01) and volume of T2LIA (> 3.2 mL, HR = 4.22, 95% CI 1.92–9.29); p < 0.01). At multivariate analysis, metastatic disease (HR = 6.89, 95% CI 2.79–16.97; p < 0.01), other subtypes (HR = 9.50, 95% CI 2.81–32.13; p < 0.01), and greater volume of T2LIA (HR = 2.51, 95% CI 1.04–6.05; p = 0.04) remained independently associated with worse survival. Conclusion T2LIAs were present in approximately two thirds of sarcomatoid RCCs. Volume of T2LIA along with clinicopathological factors were associated with survival.https://doi.org/10.1186/s40644-023-00535-0SarcomatoidRenal cell carcinomaMagnetic resonance imagingSurvivalPrognosis
spellingShingle Monica Cheng
Cihan Duzgol
Tae-Hyung Kim
Soleen Ghafoor
Anton S. Becker
Pamela I. Causa Andrieu
Natalie Gangai
Hui Jiang
Abraham A. Hakimi
Hebert A. Vargas
Sungmin Woo
Sarcomatoid renal cell carcinoma: MRI features and their association with survival
Cancer Imaging
Sarcomatoid
Renal cell carcinoma
Magnetic resonance imaging
Survival
Prognosis
title Sarcomatoid renal cell carcinoma: MRI features and their association with survival
title_full Sarcomatoid renal cell carcinoma: MRI features and their association with survival
title_fullStr Sarcomatoid renal cell carcinoma: MRI features and their association with survival
title_full_unstemmed Sarcomatoid renal cell carcinoma: MRI features and their association with survival
title_short Sarcomatoid renal cell carcinoma: MRI features and their association with survival
title_sort sarcomatoid renal cell carcinoma mri features and their association with survival
topic Sarcomatoid
Renal cell carcinoma
Magnetic resonance imaging
Survival
Prognosis
url https://doi.org/10.1186/s40644-023-00535-0
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