Impact of rhabdoid differentiation on prognosis for patients with grade 4 renal cell carcinoma

Ben Y. Zhang, John C. Cheville, R. Houston Thompson, Christine M. Lohse, Stephen A. Boorjian, Bradley C. Leibovich, Brian A. Costello

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Renal cell carcinoma (RCC) with rhabdoid differentiation is thought to portend a poor prognosis, similar to RCC with sarcomatoid differentiation. Both features are currently classified as grade 4 RCC based on the most recent International Society of Urological Pathology (ISUP) grading system.We reviewed a large series of patients with grade 4 RCC to determine the differential effects of rhabdoid and sarcomatoid differentiation on patient outcome. We identified 406 patients with ISUP grade 4 RCC including 111 (27%) with rhabdoid differentiation. In multivariable analysis of grade 4 RCC tumors, the presence of rhabdoid differentiation was not associated with death from RCC (hazard ratio [HR]: 0.95; p = 0.75); in contrast, sarcomatoid differentiation was significantly associated with death from RCC (HR: 1.63; p < 0.001). Patients with RCC with rhabdoid differentiation were significantly more likely to die of RCC than a comparison cohort of 1758 patients with grade 3 RCC (HR: 2.45; p < 0.001). The novel findings of our study suggest that rhabdoid and sarcomatoid differentiation should not be grouped together when assessing risk in a patient with grade 4 RCC but support the notion that rhabdoid differentiation is appropriately placed in the ISUP grade 4 category.

Original languageEnglish (US)
Pages (from-to)5-7
Number of pages3
JournalEuropean urology
Issue number1
StatePublished - 2015


  • Prognosis
  • Renal cell carcinoma
  • Rhabdoid differentiation
  • Sarcomatoid differentiation
  • Survival

ASJC Scopus subject areas

  • Urology


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