Background: Kidney cancer is one of the most prevalent cancers in urology. The higher prevalence of risk factors, as well as better diagnostic modalities, has led to a reported increase worldwide. The study aims to describe the profile and management pattern of kidney cancer patients at a tertiary referral center over seven years.Methods: A descriptive study was conducted to assess the profile and management of kidney patients in the national cancer center (NCC) - Dharmais Hospital Jakarta between January 2013 and December 2020. The variables collected included age, gender, stage (AJCC staging), histopathological result, and management, using the total sampling method.Results: A total of 53 kidney cancer cases were documented in NCC - Dharmais Hospital Jakarta from 2013 to 2020. Overall, males are more prevalent than females, with a sex ratio of 2.3:1. The most frequent age group was 51–65 years. The most common histological subtype was a clear cell in the renal cell carcinoma (RCC) subtype and sarcoma in the non-RCC subtype. Noticeably, end-stage (stage IV) was found in more than half of patients (65.6%), with no patient found in stage I. Radical nephrectomy was preferable to cytoreductive nephrectomy. Conclusions: : An increasing trend of kidney cancer incidence was found between 2013 and 2020 with most patients diagnosed with stage IV.

Background: Adrenocortical carcinoma (ACC) is a rare malignancy. Currently, surgical resection offers the best chance of cure with localized tumors. However, multimodal therapy, including systemic chemotherapy and radiation therapy, is often required for locally advanced and metastatic disease to decrease these high recurrence rates.Case presentation: A 42-year-old male patient was referred from an internist due to mass in left adrenal. Solid mass with calcification on left adrenal gland within size 9 x 11,8 x 11,5 cm was found in MSCT. We performed complete surgical resection (adrenalectomy), and results from pathology anatomy were ACC functional T2N1M0 (stage 3). The patient has planned eight times chemotherapy with etoposide and carboplatin, but he decided to stop the treatment after six times due to no constitutional complaint. We found no residual mass on follow up six months after operation and patient demonstrated an excellent clinical outcome after one yearConclusion: We perform open adrenalectomy and after surgery mitotane plus etoposide, cisplatin, doxorubicin (EDP) were administered as first-line therapy, but we only did chemotherapy with etoposide and carboplatin because mitotane was not covered by patient insurance. We chose not to perform radiation therapy due to the lesser benefit of adjuvant radiotherapy, as evidenced by many studies regarding recurrence-free survival and overall survival. In our case, adrenocortical carcinoma treated with open adrenalectomy combined with 6 times chemotherapy used etoposide and carboplatin demonstrated an excellent clinical outcome after 1 years.

Objective: Adreno cortical carcinoma (ACC) is a rare malignancy. Currently, surgical resection offers the best chance of cure with localized tumor. Multimodal therapy including systemic chemotherapy and radiation therapy are often required for locally advanced and metastatic disease aims to decrease these high recurrence rates. Case(s) presentation: A 42-year-old male patient was referred from internist due to mass in left adrenal. Solid mass with calcification on left adrenal gland within size 9 x 11.8 x 11.5 cm was found in MSCT. We performed complete surgical resection (adrenalectomy), and results from pathology anatomy was ACC functional T2N1M0 (stage 3). The patient was planned eight times chemotherapy with etoposide and carboplatin, but he decided to stop the treatment after six times due to no constitutional complaint. We found no residual mass on follow up six months after operation and patient demonstrated a good clinical outcome after one year. Discussion: We perform open adrenalectomy and after surgery mitotane plus etoposide, cisplatin, doxorubicin (EDP) administered as first-line therapy but we only did chemotherapy with etoposide and carboplatin because mitotane was not covered by patient insurance. We chose to not perform radiation therapy due to lesser benefit of adjuvant radiotherapy as evidenced by many studies in term of recurrence-free survival and overall survival. Conclusion: In our case, adreno cortical carcinoma treated with open adrenalectomy combined with 6 times chemotherapy used etoposide and carboplatin demonstrated a good clinical outcome after 1 year.