Cancer Res Treat.  2014 Apr;46(2):141-147.

Clinical Features and Treatment of Collecting Duct Carcinoma of the Kidney from the Korean Cancer Study Group Genitourinary and Gynecology Cancer Committee

• Kwon KA
• Oh SY
• Kim HY
• Kim HS
• Lee HY
• Kim TM
• Lim HY
• Lee NR
• Lee HJ
• Hong SH
• Rha SY

Abstract

PURPOSE
Collecting duct carcinoma (CDC) of the kidney is an aggressive disease with a poor prognosis, accountings for less than 1% of all renal cancers. To date, no standard therapy for CDC has been established. The aim of this study is an investigation of clinicopathologic findings of CDC and correlation of the disease status with a prognosis.
MATERIALS AND METHODS
From 1996 to 2009, 35 patients with CDC were treated at eight medical centers. The diagnosis of CDC was made based on nephrectomy in 27 cases and renal biopsy in eight cases.
RESULTS
Median PFS and OS for all patients were 5.8 months (95% CI 3.5 to 9.2) and 54.4 months (95% CI 0 to 109.2), respectively. The OS of patients with Stages I-III was 69.9 months (95% CI 54.0 to 85.8), while that of patients with Stage IV was 8.6 months (95% CI 0 to 23.3), which showed a statistically significant difference (p=0.01). In addition, among patients with Stage IV, the OS of patients who received a palliative treatment (immunotherapy, chemotherapy, or targeted therapy) was 18.4 months, which was higher than the OS of patients without treatment of 4.5 months.
CONCLUSION
CDC is a highly aggressive form of renal cell carcinoma. Despite most of the treatments, PFS and OS were short, however, there were some long-term survivors, therefore, conduct of additional research on the predictive markers of the several clinical, pathological differences and their treatments will be necessary.

Keyword

Renal cell carcinoma; Kidney; Treatment; Prognosis

MeSH Terms

Biopsy
Carcinoma, Renal Cell*
Centers for Disease Control and Prevention (U.S.)
Diagnosis
Drug Therapy
Gynecology*
Humans
Kidney
Kidney Neoplasms
Nephrectomy
Palliative Care
Prognosis
Survivors

Figure

• 

  Fig. 1 Summary of treatment results. MVAC, methotrexate, vinblastin, Adriamycin, and cisplatin; IFN, interferon; NED, no evidence of disease; 5-FU, 5-fluorouracil; IL-2, interleukin-2; GMAC, gemcitabine, methotrexate, Adriamycin, and cisplatin; GP, gemcitabine and cisplatin; GC, gemcitabine and carboplatin.

• 

  Fig. 2 Progression free survival (PFS) for all patients. CI, confidence interval.

• 

  Fig. 3 Overall survival (OS). (A) OS for all patients. (B) OS for patients with stage I-III (red) and IV (green). OS, overall survival; CI, confidence interval.

Reference

1. Cohen HT, McGovern FJ. Renal-cell carcinoma. N Engl J Med. 2005; 353:2477–2490. PMID: 16339096.

2. Verdorfer I, Culig Z, Hobisch A, Bartsch G, Hittmair A, Duba HC, et al. Characterisation of a collecting duct carcinoma by cytogenetic analysis and comparative genomic hybridisation. Int J Oncol. 1998; 13:461–464. PMID: 9683779.

3. Auguet T, Molina JC, Lorenzo A, Vila J, Sirvent JJ, Richart C. Synchronus renal cell carcinoma and Bellini duct carcinoma: a case report on a rare coincidence. World J Urol. 2000; 18:449–451. PMID: 11204268.

4. Srigley JR, Eble JN. Collecting duct carcinoma of kidney. Semin Diagn Pathol. 1998; 15:54–67. PMID: 9503506.

5. Miyamoto H, Kuwamitsu O, Moriyama M, Sakanishi S, Fujii H, Fukushima S, et al. Bellini duct carcinoma of the kidney. Urol Int. 1992; 48:460–462. PMID: 1413315.

6. Kobayashi N, Matsuzaki O, Shirai S, Aoki I, Yao M, Nagashima Y. Collecting duct carcinoma of the kidney: an immunohistochemical evaluation of the use of antibodies for differential diagnosis. Hum Pathol. 2008; 39:1350–1359. PMID: 18602672.

7. Orsola A, Trias I, Raventos CX, Espanol I, Cecchini L, Orsola I. Renal collecting (Bellini) duct carcinoma displays similar characteristics to upper tract urothelial cell carcinoma. Urology. 2005; 65:49–54. PMID: 15667862.

8. Dimopoulos MA, Logothetis CJ, Markowitz A, Sella A, Amato R, Ro J. Collecting duct carcinoma of the kidney. Br J Urol. 1993; 71:388–391. PMID: 8499979.

9. Oudard S, Banu E, Vieillefond A, Fournier L, Priou F, Medioni J, et al. Prospective multicenter phase II study of gemcitabine plus platinum salt for metastatic collecting duct carcinoma: results of a GETUG (Groupe d'Etudes des Tumeurs Uro-Genitales) study. J Urol. 2007; 177:1698–1702. PMID: 17437788.

10. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000; 92:205–216. PMID: 10655437.

11. Mancilla-Jimenez R, Stanley RJ, Blath RA. Papillary renal cell carcinoma: a clinical, radiologic, and pathologic study of 34 cases. Cancer. 1976; 38:2469–2480. PMID: 1000477.

12. Kim JH, Choi WG, Yoon JY, Hwang TK, Park YH, Kim BK. A case of collecting duct carcinoma of the kidney. Korean J Urol. 1992; 33:888–891.

13. Woo JW, You SJ, Lee CK, Rhew HY. A case of collecting duct carcinoma of kidney. Korean J Urol. 1997; 38:551–554.

14. Lee JE, Won HS, Kang JH, Hong YS, Oh SN, Kim TJ, et al. Metastatic collecting duct (Bellini duct) carcinoma: a case report. Korean J Med. 2009; 77:780–786.

15. Tokuda N, Naito S, Matsuzaki O, Nagashima Y, Ozono S, Igarashi T, et al. Collecting duct (Bellini duct) renal cell carcinoma: a nationwide survey in Japan. J Urol. 2006; 176:40–43. PMID: 16753362.

16. Chao D, Zisman A, Pantuck AJ, Gitlitz BJ, Freedland SJ, Said JW, et al. Collecting duct renal cell carcinoma: clinical study of a rare tumor. J Urol. 2002; 167:71–74. PMID: 11743278.

17. Peyromaure M, Thiounn N, Scotte F, Vieillefond A, Debre B, Oudard S. Collecting duct carcinoma of the kidney: a clinicopathological study of 9 cases. J Urol. 2003; 170(4 Pt 1):1138–1140. PMID: 14501710.

18. Mejean A, Roupret M, Larousserie F, Hopirtean V, Thiounn N, Dufour B. Is there a place for radical nephrectomy in the presence of metastatic collecting duct (Bellini) carcinoma? J Urol. 2003; 169:1287–1290. PMID: 12629344.

19. Procopio G, Verzoni E, Iacovelli R, Colecchia M, Torelli T, Mariani L. Is there a role for targeted therapies in the collecting ducts of Bellini carcinoma? Efficacy data from a retrospective analysis of 7 cases. Clin Exp Nephrol. 2012; 16:464–467. PMID: 22278601.