Abstract
BACKGROUND: Renal cell carcinoma (RCC) is the most common adult kidney malignancy, yet regional data from the Middle East are limited. This study characterized the clinicopathological, immunohistochemical, and survival features of RCC in a Jordanian cohort. METHODS: A retrospective analysis of 295 RCC cases (2020-2024) from Yarmouk University affiliated hospitals was conducted. Clinical and pathological parameters, immunohistochemical markers, and survival were analyzed using Kaplan-Meier and log-rank tests. RESULTS: Clear-cell RCC was the predominant subtype (72.2%), followed by papillary (10.5%), chromophobe (9.1%), and others (8.1%). The mean age was 62.1 years, with male predominance (66.4%). Clear-cell RCC showed higher rates of high-grade histology, sarcomatoid and rhabdoid differentiation, capsule invasion, renal vein involvement, and metastasis (p < 0.05), while chromophobe RCC was indolent with no metastases. CK7, Hale's iron, and c-kit characterized chromophobe RCC, vimentin was typical of clear-cell, and AMACR of papillary RCC. Survival was significantly worse with older age, higher T stage, sarcomatoid features, and higher ISUP grade, while nephrectomy type had no effect. CONCLUSIONS: Clear-cell RCC demonstrated aggressive pathology, whereas chromophobe RCC was indolent. Age, subtype, stage, and sarcomatoid features were key prognostic factors, highlighting the need for early detection and expanded nephron-sparing surgery in the region.