Increased risk for renal cell carcinoma in end stage renal disease – a population-based case-control study

Abstract

Purpose: End-stage renal disease (ESRD) is a known risk factor for the development of renal cell carcinoma (RCC). This case-control study was performed to assess the risk in a nationwide cohort and evaluate tumor characteristics and survival in the ESRD-RCC population. Methods: In this study, 9,299 patients with RCC identified in the National Swedish Kidney Cancer Register from 2005 until 2014 and 93,895 matched controls were linked to the Swedish Renal Registry and the National Patient Register. ESRD was defined as chronic kidney disease stage 5, kidney transplantation or kidney dialysis 0-40 years before the diagnosis of RCC. Results: A total of 117 patients with ESRD and subsequent RCC were identified and compared with 9,087 patients with RCC. There was a 4.5-times increased risk for RCC among ESRD patients (95% CI ¼ 3.6-5.6; p < 0.001) compared to matched controls. Longer time with ESRD increased the risk of RCC (ESRD > 9 years, OR ¼ 10.2, 95% CI ¼ 7.0-14.8). The ESRD-RCC patients were younger (p ¼ 0.002), had smaller tumors (p < 0.001) and had lower tumor stage (p ¼ 0.045). The incidence of papillary and chromophobe RCC was higher and clear cell RCC lower among the ESRD patients (p < 0.001). The 5-year overall survival was 50% in ESRD-RCC patients and 63% in RCC-only patients (p < 0.05). Conclusion: More than 9 years with ESRD increased the risk of developing RCC 10-times compared to individuals without ESRD and the tumors showed a different histopathological pattern. Despite a less advanced tumor stage at diagnosis, the overall survival in ESRD-RCC patients was lower compared to patients with RCC-only.

Influenza vaccination is associated with lower risk of renal cell carcinoma among chronic kidney disease patients: a population-based cohort study

“…Since the underlying immunologic dysfunction of CKD is related with RCC risk [ 13 ] [ 67 ], the influenza vaccination–induced immunomodulation might explain its possible protective effects. Dialysis patients had a several-fold increase in the prevalence of RCC, regardless of the underlying cause [ 68–70 ]. We found that dialysis patients with influenza vaccination had a lower risk of RCC than those who were unvaccinated.…”

Retroperitoneal lipoma and bilateral renal cell carcinoma in a rare co-existence

“…ESRD is a global health burden, with an overall prevalence of 823 patients per million population [11] . In addition, ESRD is associated with a higher risk of cardiovascular disease and cancer.…”

“…It has previously been shown that around 2–7 % of patients with ESRD develop RCC and this risk with time. RCC in ESRD patients presents predominantly as small, low-stage and low-grade tumors [11] . Due to this increased risk, many providers have opted to perform regular screening for patients with ESRD on dialysis, although guidelines describing the optimal imaging modality (ultrasound vs. CT vs. MRI), screening intervals, and target population have yet to be established [19] , [20] .…”

“…Given this risk, the typical approach in equivocal cases is surgical excision if feasible, followed by postoperative pathological assessment of the tumor to make the diagnosis and guide future management [10] . Renal cell carcinoma (RCC) is a common cancer of the urogenital system and accounts for 3 % of all malignant tumors [11] . In this report, we present a case of large retroperitoneal lipoma associated with RCC in a patient on a kidney transplant waiting list, which is to date the first identified case.…”

Onkologische Relevanz neurourologischer Erkrankungen

“…Auf der anderen Seite ist bekannt, dass eine chronische terminale Niereninsuffizienz, die sich durchaus bei nicht oder inadäquat behandelter NLUTD entwickeln kann, das Risiko der Entstehung eines Nierenzellkarzinoms erhöht. In einer landesweiten populationsbasierten Fall-Kontroll-Studie aus Schweden [64] hatten Patienten mit einer terminalen Niereninsuffizienz ein etwa 4,5-fach erhöhtes Risiko (OR 4,5; 95%- KI 3,6), abhängig von der Dauer der terminalen Niereninsuffizienz: Nach weniger als 9 Jahren betrug die OR 2,9 (95%-KI 2,2-3,9), nach mehr als -Jahren betrug die OR 10,2 (95%-KI 7,0-14,8).…”