Effect of improved diagnosis of renal cell carcinoma on the course of the disease

Abstract

The impact of the improved diagnosis of renal cell carcinoma (RCC) on the course of the disease was evaluated in 188 patients who were diagnosed and treated at a single medical center. Sixty-seven patients (group A) who had undergone nephrectomy between 1979 and 1983 for RCC initially diagnosed by intravenous pyelography (IVP) were compared with 121 patients (group B) who had undergone nephrectomy between 1983 and 1989, diagnosed by ultrasound and/or computed tomography (CT) scan. Incidental asymptomatic tumors were found in 18 of 67 (26.9%) group A patients and in 57 of 121 (47.1%) group B patients (P < 0.001). The incidence of small tumors of < 5 cm in diameter was significantly lower in group A compared to group B (25.4% vs. 47.9%, respectively, P < 0.01). The disease-free 5-year survival rate for group A was 40% compared to 80% for group B. It is concluded that the introduction of modern imaging techniques has improved the survival of patients with RCC and decreased the progression rate of the disease.

Pathologic findings at the time of nephrectomy for renal mass

“…Conversely, the present results demonstrate that most non-RCC (65%) are incidentally discovered. This finding parallels the well-documented increase in incidental renal cell carcinomas (and consequent downward stage migration among newly diagnosed cases) resulting from the increased use of US and CT in the evaluation of nonspecific abdominal complaints (8,(13)(14)(15)(16)(17). Refinement of CT techniques, including recognition of the importance of pre-and postcontrast imaging (2) and the development of spiral CT (18) has led to continued improvement in diagnostic accuracy, with concomitant reassessment of the operative indications for incidentally discovered renal tumors.…”

Prognostic Value of Renal Cell Carcinoma Nuclear Grading: Multivariate Analysis of 333 Cases

“…In the USA, 30,000 new cases and 11,900 deaths were reported in 1999 [1]. Epidemiologic data show that the incidence of RCC has increased in the last 20 years all over the world, due at least in part to the increase in incidental RCC diagnosed by means of ultrasound or CT [2][3][4].…”

Impact of Noninvasive Imaging on Increased Incidental Detection of Renal Cell Carcinoma

“…A variety of studies have examined the impact of detection methods on detection of primary, histologically confirmed renal cell carcinoma [11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27]. Various definitions have been utilized to discriminate between incidental and nonincidental tumors.…”

“…The advent of modern imaging techniques during the 1980s resulted in increased numbers of incidentally detected tumors, earlier detection of renal tumors, and enhanced survival [8, 9, 10]. …”