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4 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Collecting duct carcinoma is a rare, aggressive kidney cancer that starts in the tubes deep in the kidney that collect urine. It is treated with surgery where possible and the platinum chemotherapy used for bladder cancer, not the usual kidney cancer drugs, which do not work in it. It is usually advanced when found: 74.4 percent of 286 US SEER patients were stage III or IV.
Collecting duct carcinoma is a high-grade adenocarcinoma of the distal nephron, medullary in location, with tubular or tubulopapillary growth and a desmoplastic stroma; the 2022 WHO classification keeps it as a type and separates SMARCB1-deficient renal medullary carcinoma, its closest relative, as a molecularly defined type (Moch 2022). In a series of 39 collecting duct and 13 renal medullary carcinomas, both favoured the right kidney, centred on the medulla, averaged 7 cm, and showed poorly differentiated histology with desmoplasia, inflammation, lymphovascular invasion and perinephric extension in nearly all (Am J Surg Pathol 2012). In SEER, 74.4 percent presented at stage III or IV and most tumours were under 7 cm (Frontiers in Oncology 2021).
How it differs from its parent: renal cell carcinoma's VEGF and checkpoint pathways do not carry over; a systematic review found a 26 percent objective response to gemcitabine with cisplatin or carboplatin in 23 patients with metastatic disease and no response to immunotherapy in 49 patients treated in two older studies (Current Oncology 2013).
| Setting | Approach | Guideline |
|---|---|---|
| All stages | Nephrectomy where resectable; gemcitabine with cisplatin or carboplatin for metastatic disease, borrowed from urothelial cancer; renal cell carcinoma drugs have little evidence here. | not mapped |