Clinicopathological insights into the morphological spectrum of renal cell carcinoma: A combined prospective cross-sectional study

Abstract

Background: Renal cell carcinoma (RCC) is the most common primary malignant tumor of the kidney and comprises diverse histological subtypes with varying biological behavior and prognosis. Histopathological evaluation remains the cornerstone for accurate diagnosis and prognostic assessment. Aims and Objectives: The aim of the study is to evaluate the morphological spectrum of RCC and correlate its histological subtypes with clinicopathological parameters. Materials and Methods: A combined prospective and retrospective cross-sectional study was conducted on 40 histopathologically confirmed cases of RCC. Relevant demographic and clinicopathological data were retrieved from medical records, and nephrectomy specimens were reviewed using routine hematoxylin and eosin-stained sections. Tumors were classified according to the World Health Organization (WHO) classification, graded using the WHO/International Society of Urological Pathology (ISUP) grading, and staged using the tumor, nodes, and metastasis system. Data were analyzed using appropriate statistical methods. Results: The mean age of the patients was 57.8±10.9 years, with a male-to-female ratio of 1.9:1. Clear cell RCC (ccRCC) was the predominant subtype (65%), followed by papillary (22.5%), chromophobe (10%), and collecting duct carcinoma (2.5%). Most tumors were WHO/ISUP Grade II (45%) and stage I (45%). Higher nuclear grade and advanced pathological stage were observed in ccRCC. Tumor necrosis, lymphovascular invasion, and perinephric fat invasion were more frequently associated with high-grade tumors. Conclusion: ccRCC was the most common morphological subtype and demonstrated a greater association with adverse pathological features. Histopathological assessment remains an indispensable and cost-effective tool for tumor classification and prognostic stratification. However, the relatively small sample size and single-center design limit the generalizability of the findings. Larger multicentric studies are warranted to validate these observations.