Research Paper

A CLINICO PATHOLOGICAL STUDY ON RENAL CELL CARCINOMA IN A TERTIARY CARE CENTER

  Abstract :

Background :The incidence of renal cell cancer (RCC) is increasing worldwide. However, scant information is available from the India, about its clinicopathological characteristics and survival outcomes. We prospectively analyzed data of patients suffering from RCC at Department Urology, Andhra Medical College & King George Hospital, Visakhapatnam, from October 2015 to January 2018 to generate information on these aspects.Materials and Methods : 32 patients treated between October 2015 to January 2018 were prospectively analyzed. Baseline characteristics, histopathological information, and survival outcomes were assessed. Results: The peak incidence of RCC was seen in 5th decade followed by 4th decade. The mean age at presentation was 52.45 years. Incidence is higher in males than in females with a ratio of 2.3:1. Smoking is associated with 45% of cases and hypertension in 34% of cases. The classic triad of RCC was seen only in 3 cases (8%). The mean tumour size was 10.25cm, range 5-19 cm. Only 5% of tumours were of size less than 4cm. 31% cases were in stage 1, 30% in stage 2 , 31 % in stage 3 and 8% in stage 4. Tumours are localized in 57%, locally advanced in 31 % and metastatic in 9%.Partial nephrectomy was done in only 2(5%) cases . Open Radical nephrectomy was done in 85% of cases. Post op biopsy showed Clear cell RCC variant in 22 (68%) and papillary carcinoma in 7 (21%),multilocular cyst in 1 (3%) and malignant fibrous histiocytoma in 1 case(3%). 75% of cases showed Fuhrman's grade 2 and 25% showed grade 3. Capsular invasion was seen in 21% and lymph nodal positivity for metastatic deposits in 12% and 34% showed necrosis. 5 Deaths were noted. 3 cases missed the follow up after surgery. All cases were advised 6 monthly ultrasound abdomen and chest X ray.conclusions: Younger age at presentation, higher malefemale ratio, lower proportion of asymptomatic patients, higher proportion of advanced stage at diagnosis, smoking & hypertension more commonly associated with RCC. clear cell and papillary variants of RCC are more common.

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