# Collecting duct carcinoma of the kidney

Source: https://onco.cc/cancers/collecting-duct-carcinoma/  
OnCo record `collecting-duct-carcinoma` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Collecting duct carcinoma is a very rare, aggressive kidney cancer that starts in the tubes deep in the kidney that collect urine. It is usually found after it has spread, does not respond to the usual kidney cancer drugs, and is treated with the platinum chemotherapy used for bladder cancer, with surgery where possible.

## Summary

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).

How common: 286 US cases in 15 years (Frontiers in Oncology 2021).

Treatment: nephrectomy where the disease is resectable; gemcitabine with cisplatin or carboplatin for metastatic disease, borrowed from urothelial cancer, as the review describes; checkpoint inhibitor combinations are used off the renal cell carcinoma pathway without trial evidence in this type (Current Oncology 2013).

## Fields

- Kind: Cancer
- Last checked: 2026-09-24
- Also known as: Bellini duct carcinoma; Carcinoma of the collecting ducts of Bellini; Collecting duct renal cell carcinoma; Collecting duct and medullary (SMARCB1)
- Tags: subtype-page; wave4; kidney; rare
- Group: genitourinary
- Burden: Very rare and falling: 286 patients in the US SEER registry over 2004 to 2018, median age 59, 67.5 percent men, 74.4 percent stage III or IV at diagnosis (Frontiers in Oncology 2021). Cancer Research UK lists clear cell at 70 to 80 percent, papillary 5 to 10 and chromophobe 3 to 5 percent of renal cell cancers; collecting duct carcinoma is well under 1 percent.
- Subtypes: Collecting duct carcinoma, classic (medullary epicentre, desmoplastic; right kidney predilection); Collecting duct carcinoma with sarcomatoid change; SMARCB1-deficient renal medullary carcinoma (own page; formerly grouped here)
- Biomarkers: Retained SMARCB1 (INI1) expression, distinguishing it from renal medullary carcinoma; High nuclear grade and lymphovascular invasion; Stage at diagnosis (three quarters III or IV)

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/collecting-duct-carcinoma/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/collecting-duct-carcinoma/#overview
- What it is (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/collecting-duct-carcinoma/#what-it-is [3 subtypes]
- Finding it (on the hub): How it shows itself, how it is confirmed, what screening exists, and the biomarkers clinicians test for. https://onco.cc/cancers/collecting-duct-carcinoma/#finding-it [3 biomarkers]
- Treating it (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/collecting-duct-carcinoma/#treating-it [1 setting, 1 decision with options]
- Evidence (on the hub): Trials recruiting now, the landmark trials, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/collecting-duct-carcinoma/#evidence
- The science (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/collecting-duct-carcinoma/#science
- Where you are (own page): Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record. https://onco.cc/cancers/collecting-duct-carcinoma/where-you-are/
- Living with it (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/collecting-duct-carcinoma/#living-with-it [8 questions, 4 red cards]
- What is coming (own page): Everything in development, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/collecting-duct-carcinoma/coming/ [4 medicines]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/collecting-duct-carcinoma/data/ [10 connected records]

## Standard of care

- 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. ([Nephrectomy](https://onco.cc/terms/nephrectomy/), [Gemcitabine + cisplatin](https://onco.cc/drugs/gemcitabine-cisplatin/), [Carboplatin](https://onco.cc/drugs/carboplatin/), [Renal cell carcinoma](https://onco.cc/cancers/rcc/))

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Collecting_duct_carcinoma
- NCI PDQ: renal cell cancer treatment: https://www.cancer.gov/types/kidney/patient/kidney-treatment-pdq
- Cancer Research UK: types and grades of kidney cancer: https://www.cancerresearchuk.org/about-cancer/kidney-cancer/stages-types-grades/types-grades
- Moch 2022, European Urology: the 2022 WHO classification of urinary and male genital tumours, part A (renal, penile, testicular): https://doi.org/10.1016/j.eururo.2022.06.016
- Frontiers in Oncology 2021: collecting duct carcinoma of the kidney, 286 SEER patients 2004 to 2018: https://doi.org/10.3389/fonc.2021.727222
- Current Oncology 2013: management of renal collecting duct carcinoma, systematic review: https://doi.org/10.3747/co.20.1230
- Am J Surg Pathol 2012: collecting duct carcinoma and renal medullary carcinoma, 52 cases: https://doi.org/10.1097/pas.0b013e3182635954

## Connected records

- cancers: [Bladder & urothelial cancer](https://onco.cc/cancers/urothelial/), [Fumarate hydratase-deficient renal cell carcinoma (HLRCC-associated)](https://onco.cc/cancers/fh-deficient-renal-cell-carcinoma/), [Papillary renal cell carcinoma](https://onco.cc/cancers/papillary-rcc/), [Renal cell carcinoma](https://onco.cc/cancers/rcc/), [Renal medullary carcinoma (SMARCB1-deficient)](https://onco.cc/cancers/renal-medullary-carcinoma/), [TFE3-rearranged (translocation) renal cell carcinoma](https://onco.cc/cancers/tfe3-rearranged-renal-cell-carcinoma/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Cisplatin](https://onco.cc/drugs/cisplatin/), [Gemcitabine](https://onco.cc/drugs/gemcitabine/), [Gemcitabine + cisplatin](https://onco.cc/drugs/gemcitabine-cisplatin/)
- terms: [Nephrectomy](https://onco.cc/terms/nephrectomy/)

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JSON: https://onco.cc/api/v1/entities/collecting-duct-carcinoma.json