Histologic re‑evaluation of a population‑based series of renal cell carcinomas from The Netherlands Cohort Study according to the 2022 ISUP/WHO classification

Selena Odeh; Iryna V Samarska; Andres Matoso; Jeroen A A Van De Pol; Marcella M L L Baldewijns; Christina A Hulsbergen-Van De Kaa; Jaleesa Van Der Meer; Guido Roemen; Erik Geelkens; Manon Van Engeland; Axel Zur Hausen; Leo J Schouten; Kim M Smits

doi:10.3892/ol.2023.13760

Histologic re‑evaluation of a population‑based series of renal cell carcinomas from The Netherlands Cohort Study according to the 2022 ISUP/WHO classification

Oncol Lett. 2023 Mar 15;25(5):174. doi: 10.3892/ol.2023.13760. eCollection 2023 May.

Authors

Selena Odeh¹, Iryna V Samarska¹, Andres Matoso^{2

3

4}, Jeroen A A Van De Pol⁵, Marcella M L L Baldewijns^{1

6}, Christina A Hulsbergen-Van De Kaa^{7

8}, Jaleesa Van Der Meer¹, Guido Roemen¹, Erik Geelkens¹, Manon Van Engeland¹, Axel Zur Hausen¹, Leo J Schouten⁵, Kim M Smits¹

Affiliations

¹ Department of Pathology, School for Oncology and Reproduction (GROW), Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands.
² Department of Pathology, Johns Hopkins University, Baltimore, MD 21218, USA.
³ Department of Urology, Johns Hopkins University, Baltimore, MD 21218, USA.
⁴ Department of Oncology, Johns Hopkins University, Baltimore, MD 21218, USA.
⁵ Department of Epidemiology, School for Oncology and Reproduction (GROW), Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands.
⁶ Department of Histopathology, University of Leuven, 3000 Leuven, Belgium.
⁷ Department of Pathology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.
⁸ Laboratory of Pathology East Netherlands (LABPON), 7550 AM Hengelo, The Netherlands.

Abstract

The aim of the present study was to re-evaluate 457 renal cell carcinoma (RCC) cases from the Netherlands Cohort Study on Diet and Cancer (NLCS), a large population-based cohort, according to the new 2022 ISUP, Genitourinary Pathology Society and World Health Organisation (WHO) classifications to assess whether newly recognized subtypes of RCC could be found among these cases. These cases were initially evaluated according to the 2004 WHO classification, the Fuhrman grading system and the 3rd version of the Tumor-Node-Metastasis (TNM). Data on tumor size, laterality and date of diagnosis, among other clinicopathological characteristics, were obtained through record linkage with the Netherlands Cancer Registry and the Pathologisch-Anatomisch Landelijk Geautomatiseerd Archief. Digital slides from the NLCS were reviewed by two urogenital pathologists according to the new ISUP grading and the 2022 WHO classification (5th edition). Immunohistochemistry staining for carbonic anhydrase IX was performed on cases with ambiguous morphology. A total of 373 cases of clear cell RCC (ccRCC), 61 cases of papillary RCC (pRCC), 13 cases of chromophobe RCC, 3 cases of collecting duct carcinoma and 4 cases of oncocytoma were identified. The subtyping showed no discrepancy with the previous diagnoses. A comparison of the WHO/ISUP grading to the original Fuhrman grading showed a similar grading in 245 (56.5%) cases of the total ccRCC and pRCC cases. The staging according to the novel TNM classification 8th edition showed a restaging in 286 cases (65.5%). Lymphovascular (microvascular) invasion (LVI) and tumor necrosis (TN) were present in 14.4% and 33.5% of the total number of cases, respectively. Furthermore, the presence of sarcomatoid differentiation in 5.1% and rhabdoid differentiation in 4.2% of the cases was observed. In conclusion, none of the newly accepted and emerging/provisional RCC entities were identified in the NLCS cases, which could be attributed to the high mean age (71.4 years) at diagnosis of the patients included in the present study. A restaging of the NLCS cases using the TNM 8th edition and regrading using ISUP grading was performed, which showed that it is possible to report on newer features, such as sarcomatoid differentiation and LVI, even in an old sample collection.

Keywords: ISUP grading; LVI; TNM 8th edition; necrosis; newly described RCC entities; rhabdoid and sarcomatoid features.

Grants and funding

This work was supported by the PPP Allowance made available by Health Holland, Top Sector Life Sciences and Health, to stimulate public-private partnerships [grant no. LSHM17059 (Prognosis Renal Cancer and Detection, PRECEDE)].