Decadal Experience of Renal Cell Carcinoma from a Tertiary Care Teaching Institute in North India

Abstract

To study the current trends of renal cell carcinoma (RCC) in terms of demographic characteristics, clinical presentation, staging, mode of management, histopathology, and survival characteristics from a high volume tertiary care teaching institute in North India. We retrospectively reviewed the records of all patients of RCC between January 2006 and December 2015 and variables like age, gender, symptoms, tumor size/location/number, stage, type of surgery, histopathology, and survival characteristics were studied. One hundred forty-four patients were included in the study. Most common age group of presentation was 50-59 years (29.8%), male to female ratio was 2.5, and majority of cases were smokers. Flank pain was the most common presenting complaint (38.2%), classical triad (pain, fever, hematuria) was present in 25%, and incidental diagnosis was made in 11.1% cases. Stage T2a was most common presentation with majority of tumors present in upper pole (27.1%). Renal vein involvement (T3a) was present in 10.4%, hilar lymph node involvement in 25%, and distant metastasis was observed in 20.1% cases. Radical nephrectomy was most common surgery performed (75%) and clear cell carcinoma was the most common histopathology (75.7%) followed by papillary (11.1%). Women reported more chromophobe type and low-grade cancers, although rest of clinico-pathological features did not show any gender difference. Mean follow-up of the study was 6-122 months with younger (< 29 years) patients reporting lower 5-year survival and higher stage disease. Renal cell carcinoma shows a different trend in our study population, compared to western data, with large size tumors and advanced stage presentation being more common.

Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

“…Our study reports that the disease is more common among males (58.5%) and in the fifth decade of life (mean=52.6 years). This was comparable to a study by Kawaljit et al in 2018, who reported the disease as most common in the 50-59 age group, followed by 60-69 years. In their study, predominantly affected patients were males, with a much greater percentage of 71.5%.…”

“…However, it is still regarded as the deadliest urological cancer worldwide. 9 Survival rate largely depends on the stage of the tumour at the time of diagnosis. Early diagnosis followed by early treatment results in a better prognosis, but as the Fuhrman Grades progress to III and IV, the survivability of the patient reduces considerably.…”

“…Histopathological findings were also noted, and based on these findings, and the RCC was further sub-classified into its types such as clear cell carcinoma, papillary carcinoma etc. Fuhrman grading criteria, 9 were used for the tumour grading based on histopathological findings, as shown in Table-I.…”

Renal cell carcinoma at the time of presentation: a 5-year radiological survey at a tertiary care cancer hospital

“…19 A study done in India has shown that most prevalent stage in .the patients of RCC presenting to them was stage 2 seen in 45.5% patients. 25 Different stages prevalence is seen in literature showing variations among developed and under developed countries indicating the health awareness, basic health facilities and socioeconomic status in the country.…”