Pathologic validation of renal cell carcinoma histology in the Surveillance, Epidemiology, and End Results program

Abstract

Purpose The Surveillance, Epidemiology, and End Results (SEER) program is an important epidemiologic research tool to study cancer. No information is available on its pathologic accuracy for renal cell carcinoma (RCC). Methods Central pathology review was analyzed as a part of the United States Kidney Cancer Study. Cases previously identified through the Detroit SEER registry were reviewed. The sensitivity and specificity, and positive and negative predictive values were calculated for each SEER-assigned subtype, with the central review assignments used as the reference. Results Of the 498 cases included in this study, 490 (98.5%) were confirmed to be RCC. The overall agreement for histology was 78.2% (k = 0.55); however, individual cases were frequently reclassified. The sensitivity and specificity for SEER-assigned clear cell RCC were 79.1% and 88.1%, respectively, when based solely on the ICD-O-3 morphology code 8310 (n = 310), and 99.2% and 80.5% when 8312 (RCC not otherwise specified; n = 41) was also assumed to be clear cell. Although RCC not otherwise specified is frequently grouped with clear cell, only 78.1% had this histology. Assignments of papillary and chromophobe RCC had comparable sensitivities (73.5% and 72.4%, respectively) and specificities (97.5% and 97.6%). Positive predictive values for clear cell (excluding/including 8312), papillary, and chromophobe RCC were 95.5%/93.5%, 85.9%, and 65.6%, respectively. Conclusions Our findings confirm that nearly all RCC cases are correctly classified in SEER. The positive predictive value was higher for clear cell RCC than for papillary or chromophobe RCC, suggesting that pathologic confirmation may be warranted for studies of non–clear cell tumors. Published by Elsevier Inc.

A Gap in Disease-Specific Survival Between Younger and Older Adults With De Novo Metastatic Renal Cell Carcinoma: Results of a SEER Database Analysis

“…To account for this, we have limited our analyses to patients in whom a specific histologic type consistent with RCC was noted (ie, clear cell, papillary, and chromophobe). A recent study by Shuch et al 17 suggested that these diagnoses were recorded in SEER with substantial precision. Missing data are another issue in SEER, with several variables relevant to RCC not recorded.…”

Risk factors for metachronous bilateral renal cell carcinoma: A Surveillance, Epidemiology, and End Results analysis

“…For patients with multiple second diagnoses of kidney cancer, the earliest diagnosis was used as the reference. Previously published International Classification of Diseases for Oncology (3rd edition) histologic/behavior codes were used to classify patients with RCC . Only microscopically confirmed cases of RCC were included.…”

“…Previously published International Classification of Diseases for Oncology (3rd edition) histologic/behavior codes were used to classify patients with RCC. 9 Only microscopically confirmed cases of RCC were included. To avoid synchronous bilateral tumors having staged surgical management, patients were excluded if their second diagnosis was within 1 year of primary diagnosis or if follow-up time was less than 12 months.…”

The effect of age on cancer-specific mortality in patients with small renal masses: A population-based analysis

“…Only patients with clear cell (ccRCC) (histologic code 8310 and 8312) [8,9], chromophobe (chRCC) (histologic code 8317) [10] and papillary (pRCC) (histologic code 8260) [11] histology were considered. All were surgically treated with either partial or radical nephrectomy.…”