Gender‐specific clinicopathological features and survival in patients with renal cell carcinoma (RCC)

Study Type – Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? There has been some controversy about the gender differences in survival in patients with RCC. Korean women with RCC had a lower proportion of clear cell histology and a higher proportion of chromophobe histology. This histological difference might have driven the better survival rates in Korean women. OBJECTIVE To assess whether there are gender‐specific differences in the clinicopathological features and prognosis in a large cohort of Korean patients with renal cell carcinoma (RCC) compared with Western patients. PATIENTS AND METHODS Medical records of 1616 patients clinically diagnosed with RCC who underwent partial or radical nephrectomy were analysed between January 1988 and July 2009. In all, 1508 patients diagnosed with RCC based on pathology reports were included for evaluation. The mean follow‐up period was 73.1 months. The gender‐specific differences in the clinicopathological features and survival rates were evaluated using the Kaplan–Meier method and Cox proportional hazards models. RESULTS Of the 1508 patients, 439 (29.1%) were women. Korean men had a higher proportion of clear cell histology (84.3% vs 72.0%, P < 0.001) and a lower percentage of chromophobe histology (5.2% vs 12.5%, P < 0.001) than Korean women. There were no gender‐specific differences in pathological T stage, positive lymph nodes or distant metastases, or Fuhrman's nuclear grade ( P > 0.05). For both cancer‐specific and overall survival, Kaplan–Meier curves showed that women had a better survival rate than men ( P = 0.039 and P = 0.015, respectively). CONCLUSIONS Korean women with RCC had significantly better survival rates than Korean men. Additionally, Korean women with RCC had a lower proportion of clear cell histology and a higher proportion of chromophobe histology. This histological difference might have driven the better survival rates in Korean women.