BACKGROUND It is controversial whether chromophobe renal cell carcinoma (chRCC) or clear cell renal cell carcinoma (ccRCC) is associated with better survival. We conducted a clinical-based cohort study and meta-analysis to evaluate the prognostic role of histology between chRCC and ccRCC. METHODS A cohort of 1540 patients (166 with chRCC and 1374 with ccRCC) were selected from Sun Yat-sen University and The Cancer Genome Atlas databases. The clinicopathological parameters and overall survival (OS) were compared between patients with chRCC and those with ccRCC. For the meta-analysis, we searched the PubMed, Cochrane Library, and Ovid databases for studies comparing OS or cancer-specific survival (CSS) between chRCC and ccRCC. RESULTS The cohort study revealed that patients with chRCC were younger (median 52 vs. 55 years, P < 0.001), were more commonly female (47.0 vs. 33.0%, P < 0.001), and had a larger tumor size (mean 7.1 vs. 5.9 cm, P < 0.001), and they had a lower stage compared with those with ccRCC. Five-year OS rates for chRCC and ccRCC were 90.3 and 75.3%, respectively (P < 0.001). We found significantly better survival for chRCC in stratification analysis by age, sex, tumor size, and stage. Similar results were observed on both univariate [hazard ratio (HR), 0.30; 95% confidence interval (CI) 0.16-0.55, P < 0.001] and multivariate analyses (HR 0.42; 95% CI 0.23-0.79, P = 0.006). Ten studies were included in our meta-analysis. Eight of them provided data on univariate analysis. The pooled HR was statistically significant for OS (pooled HR 0.49; 95% CI 0.30-0.79, P = 0.004) and CSS (pooled HR 0.49; 95% CI 0.37-0.64, P < 0.001). Seven studies reported the HR on multivariate analysis. The pooled HR was also statistically significant for OS (pooled HR 0.63; 95% CI 0.51-0.77, P < 0.001) and CSS (pooled HR 0.72; 95 % CI 0.57-0.90, P = 0.003). These data indicate that patients with chRCC had better outcomes than those with ccRCC. CONCLUSIONS Our large cohort study and meta-analysis confirmed that chRCC had better survival than ccRCC.

中文翻译：

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嗜铬肾细胞癌是否比透明细胞肾细胞癌具有更好的生存率？基于临床的队列研究和荟萃分析。

背景技术发色性肾细胞癌（chRCC）或透明细胞肾细胞癌（ccRCC）与更好的生存率相关是有争议的。我们进行了一项基于临床的队列研究和荟萃分析，以评估chRCC和ccRCC之间组织学的预后作用。方法从中山大学和《癌症基因组图谱》数据库中选择了1540例患者（166例chRCC和1374例ccRCC）。比较了chRCC患者和ccRCC患者的临床病理参数和总生存期（OS）。对于荟萃分析，我们搜索了PubMed，Cochrane库和Ovid数据库，以比较chRCC和ccRCC之间的OS或癌症特异性生存率（CSS）。结果队列研究显示chRCC患者较年轻（中位年龄52岁对55岁，P <0.001），较女性为女性（47.0 vs. 33.0％，P <0.001），并且肿瘤较大（平均7.1 vs. 5.9 cm，P <0.001），并且与ccRCC相比，它们的分期较低。chRCC和ccRCC的五年OS率分别为90.3％和75.3％（P <0.001）。在按年龄，性别，肿瘤大小和阶段进行的分层分析中，我们发现chRCC的存活率明显更高。在两个单变量[危险比（HR）为0.30；风险比（HR）为0.30；95％置信区间（CI）0.16-0.55，P <0.001]和多元分析（HR 0.42； 95％CI 0.23-0.79，P = 0.006）。我们的荟萃分析包括十项研究。他们中有八个提供了单变量分析的数据。合并的HR对于OS（合并的HR 0.49; 95％CI 0.30-0.79，P = 0.004）和CSS（合并的HR 0.49; 95％CI 0.37-0.64，P <0.001）具有统计学意义。七项研究报告了多因素分析中的HR。对于OS（合并的HR 0.63; 95％CI 0.51-0.77，P <0.001）和CSS（合并的HR 0.72; 95％CI 0.57-0.90，P = 0.003），合并的HR在统计上也很显着。这些数据表明，chRCC患者比ccRCC患者具有更好的预后。结论我们的大型队列研究和荟萃分析证实，chRCC的生存率优于ccRCC。