{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:23:24Z","timestamp":1791883404619,"version":"4.3.4"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"7","funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Kidney Cancer SPORE","award":["P50CA196516"],"award-info":[{"award-number":["P50CA196516"]}]},{"name":"Jan and Bob Pickens Distinguished Professorship in Medical Science and Brock Fund for Medical Science Chair in Pathology"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The mechanisms underlying metastatic latency in renal cell carcinoma (RCC) remain poorly understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study evaluated 2 large independent cohorts for differences in tumor biology between patients who developed metastases early (\u22641\u2009year after nephrectomy) and those with late onset (&amp;gt;3\u2009years).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the discovery cohort (n\u2009=\u2009161), late metastatic RCC was associated with clear cell histology (88.9% vs 78.7%), lower pathological stage (pT1-2; 40.3% vs 18.0%), and favorable histopathological features including low grade (40.0% vs 2.3%), less sarcomatoid (5.6% vs 21.8%), and reduced necrosis (37.7% vs 78.3%; all P\u2009&amp;lt;\u2009.02). Late metastatic RCC tumors exhibited increased angiogenesis (63.5% vs 19.4%) and reduced inflammation (78.8% vs 50.0%; all P\u2009&amp;lt;\u2009.02) profiles. Genomic driver analyses revealed comparable rates of PBRM1 and SETD2 loss in late and early metastatic RCC, while BAP1 loss was significantly less common in late metastatic RCC (7.5% vs 27.1%; P\u2009&amp;lt;\u2009.02). In multivariable models, BAP1\/PBRM1\/SETD2 status and tumor necrosis emerged as key discriminators of late metastatic RCCs. These findings were confirmed in the second cohort (n\u2009=\u2009307). Late metastatic RCC was enriched for fatty acid oxidation and angiogenesis pathways, supporting a less aggressive phenotype. This was further evidenced by a lower engraftment rate in murine models (0% vs 36.5%; P\u2009&amp;lt;\u2009.001) and significantly longer overall survival from the time of metastasis (median survival doubled, P\u2009&amp;lt;\u2009.001). Interestingly, late metastatic RCC shared genomic and phenotypic features with RCC that metastasizes to the pancreas, suggesting a common underlying biology influencing both metastatic latency and pancreatic tropism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Overall, these findings advocate for recognition of late metastatic RCC because of its distinct biology and improved prognosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jnci\/djaf060","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T07:49:56Z","timestamp":1741679396000},"page":"1387-1400","source":"Crossref","is-referenced-by-count":12,"title":["Determinants of late metastases in renal cell carcinoma"],"prefix":"10.1093","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4239-0495","authenticated-orcid":false,"given":"Payal","family":"Kapur","sequence":"first","affiliation":[{"name":"Department of Pathology, University of Texas Southwestern Medical Center , Dallas, TX,","place":["United States"]},{"name":"Department of Urology, University of Texas Southwestern Medical Center , Dallas, TX,","place":["United States"]},{"name":"Kidney Cancer Program at Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center , Dallas, TX,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1962-2603","authenticated-orcid":false,"given":"Hua","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Texas Southwestern Medical Center , Dallas, TX,","place":["United States"]},{"name":"Department of Bioinformatics, University of Texas 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University of Texas Southwestern Medical Center , Dallas, TX,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen T","family":"Ball","sequence":"additional","affiliation":[{"name":"Office of Research Affairs, College of Medicine , Jacksonville, FL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D","family":"Thiel","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic , Jacksonville, FL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Parker","sequence":"additional","affiliation":[{"name":"Office of Research Affairs, College of Medicine , Jacksonville, FL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2372-9489","authenticated-orcid":false,"given":"Samuel O","family":"Antwi","sequence":"additional","affiliation":[{"name":"Office of Research Affairs, College of Medicine , Jacksonville, FL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0043-6659","authenticated-orcid":false,"given":"Brad C","family":"Leibovich","sequence":"additional","affiliation":[{"name":"Department of Pathology, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5647-5195","authenticated-orcid":false,"given":"Zora","family":"Modrusan","sequence":"additional","affiliation":[{"name":"Department of Proteomic and Genomic Technologies, Genentech , South San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C","family":"Cheville","sequence":"additional","affiliation":[{"name":"Department of Pathology, Mayo Clinic , Rochester, 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