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@ARTICLE{Wagener:128703,
      author       = {N. Wagener and D. Edelmann$^*$ and A. Benner$^*$ and R.
                      Zigeuner and H. Borgmann and I. Wolff and L. M. Krabbe and
                      M. Musquera and P. Dell'Oglio and U. Capitanio and T. Klatte
                      and L. Cindolo and M. May and S. D. Brookman-May},
      collaboration = {E. A. o. Urology},
      title        = {{O}utcome of papillary versus clear cell renal cell
                      carcinoma varies significantly in non-metastatic disease.},
      journal      = {PLoS one},
      volume       = {12},
      number       = {9},
      issn         = {1932-6203},
      address      = {Lawrence, Kan.},
      publisher    = {PLoS},
      reportid     = {DKFZ-2017-04718},
      pages        = {e0184173 -},
      year         = {2017},
      abstract     = {Renal cell carcinoma (RCC) comprises a heterogenous group
                      of tumors. Traditionally, papillary RCC (pRCC) is associated
                      with a favorable outcome compared to clear cell RCC (ccRCC),
                      while other series report equivalent or worse prognosis. In
                      this paper we comparatively evaluate outcome of pRCC versus
                      ccRCC in two large multi-institutional databases (cohort
                      study), including distribution of pRCC subtypes 1 and 2.
                      Retrospective data of 1,943 surgically treated pRCC patients
                      from 17 European/ North American centers between 1984-2015
                      were compared to 5,600 ccRCC patients from a database
                      comprising 11 European/ North American centers (1984-2011).
                      Median follow-up was 64.6 months. Differences between pRCC,
                      subtypes, and ccRCC were compared with t-tests,
                      $Chi^2-tests,$ and exact Fisher tests. Cancer-specific
                      mortality was analyzed with cumulative incidence curves and
                      Cox cause-specific hazard models. The robustness of our
                      results was examined with sensitivity analyses. We present
                      that cancer-specific mortality rates and variables as stage,
                      lymph node, and distant metastasis differ significantly
                      between groups. Furthermore, we demonstrate that patients
                      with non-metastatic pRCC had a significantly better
                      cancer-specific mortality (HR 0.76, p = 0.007), when
                      compared to ccRCC. Additionally, pRCC type 2 versus ccRCC
                      exhibited no difference in cancer-specific mortality (HR
                      0.9, p = 0.722), whereas pRCC type 1 versus ccRCC displayed
                      a risk of death reduced by $69\%$ (p = 0.044). Taken
                      together, outcome of pRCC versus ccRCC varies significantly
                      in non-metastatic disease. Furthermore, pRCC type 2
                      exhibited no difference in cancer-specific mortality,
                      whereas pRCC type 1 displayed a significantly reduced risk
                      of death. Consequently, there is urgent need to respect
                      histopathological entities and their subtypes, when
                      assigning follow-up or targeted therapy to RCC patients.},
      cin          = {C060},
      ddc          = {500},
      cid          = {I:(DE-He78)C060-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:28934212},
      pmc          = {pmc:PMC5608215},
      doi          = {10.1371/journal.pone.0184173},
      url          = {https://inrepo02.dkfz.de/record/128703},
}