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Objective <p>Chromophobe renal cell carcinoma (chRCC) is generally considered a less aggressive renal malignancy, yet a clinically meaningful subset displays adverse outcomes. We evaluated the prognostic impact of WHO/ISUP Grade IV histology on cancer-specific survival (CSS) in a large population-based, propensity score-matched cohort.</p> Methods <p>The SEER database (2000–2021) was queried for patients with chRCC. Patients were stratified according to WHO/ISUP grade into Grade IV chRCC and Grade I–III chRCC. The primary endpoint was CSS. A 2:1 nearest-neighbor PSM was performed using age, sex, race, AJCC stage, and tumor size. Fine–Gray competing-risk regression was performed in both the overall and propensity score-matched cohorts.</p> Results <p>A total of&#xa0;6243 patients with chRCC were identified, including 394 (6.3%) with Grade IV histology. In the overall cohort, Grade IV chRCC was independently associated with worse CSS (HR 2.38, 95%CI 1.78–3.18, <i>p</i> &lt; 0.001). After PSM (<i>n</i> = 1107), this association persisted (HR 1.96, 95%CI 1.43–2.69, <i>p</i> &lt; 0.001) and was supported by competing-risk analysis in both the overall cohort (sHR 2.07, 95% CI 1.53–2.79, <i>p</i> &lt; 0.001) and the matched cohort (sHR 1.80, 95%CI 1.32–2.46, <i>p</i> &lt; 0.001).</p> Conclusion <p>In this large, propensity score-matched, population-based cohort, WHO/ISUP Grade IV chRCC was independently associated with poorer CSS, even after adjustment for tumor burden and stage. These findings should be interpreted within the limitations of registry-defined Grade IV classification.</p>

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Does WHO/ISUP grade IV histology provide prognostic insight in chromophobe renal cell carcinoma?

  • 期刊论文

  • 发表日期：

    2026年7月2日

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  • Serdar Turan,
  • Selcuk Erdem,
  • Selman Mert,
  • Nusret Can Çilesiz,
  • Arda Tunc Aydinoglu,
  • Can Balci

摘要

Objective

Chromophobe renal cell carcinoma (chRCC) is generally considered a less aggressive renal malignancy, yet a clinically meaningful subset displays adverse outcomes. We evaluated the prognostic impact of WHO/ISUP Grade IV histology on cancer-specific survival (CSS) in a large population-based, propensity score-matched cohort.

Methods

The SEER database (2000–2021) was queried for patients with chRCC. Patients were stratified according to WHO/ISUP grade into Grade IV chRCC and Grade I–III chRCC. The primary endpoint was CSS. A 2:1 nearest-neighbor PSM was performed using age, sex, race, AJCC stage, and tumor size. Fine–Gray competing-risk regression was performed in both the overall and propensity score-matched cohorts.

Results

A total of 6243 patients with chRCC were identified, including 394 (6.3%) with Grade IV histology. In the overall cohort, Grade IV chRCC was independently associated with worse CSS (HR 2.38, 95%CI 1.78–3.18, p < 0.001). After PSM (n = 1107), this association persisted (HR 1.96, 95%CI 1.43–2.69, p < 0.001) and was supported by competing-risk analysis in both the overall cohort (sHR 2.07, 95% CI 1.53–2.79, p < 0.001) and the matched cohort (sHR 1.80, 95%CI 1.32–2.46, p < 0.001).

Conclusion

In this large, propensity score-matched, population-based cohort, WHO/ISUP Grade IV chRCC was independently associated with poorer CSS, even after adjustment for tumor burden and stage. These findings should be interpreted within the limitations of registry-defined Grade IV classification.