Korean J Urol.  2011 Feb;52(2):110-114.

Changes in Clinicopathological Characteristics of Renal Cell Carcinoma in the Past 25 Years: A Single-Center Experience

• Choi JB
• Yoon BI
• Kim SJ
• Cho HJ
• Hong SH
• Choi YJ
• Kim SW
• Hwang TK
• Lee JY

Abstract

PURPOSE
We examined changes in the clinicopathologic characteristics of renal cell carcinoma (RCC) in the past 25 years and aimed to obtain indicators for its diagnosis and treatment.
MATERIALS AND METHODS
The medical records of 563 patients with confirmed primary RCC after surgical treatment from 1985 to 2010 at Seoul St. Mary's Hospital were retrospectively reviewed. Patient and tumor characteristics were compared over 3 time periods (period 1: 1985-1994, period 2: 1995-2004, period 3: 2005-2010).
RESULTS
Period 1 included 65 patients, period 2 included 183 patients, and period 3 included 315 patients, showing an exponential growth in the number of patients. Frequency was highest in the late 50s age group. The review of clinical symptoms showed that incidental diagnosis increased significantly. The tumor size at diagnosis gradually decreased and the proportion of small tumors less than 4 cm increased remarkably. Concerning tumor spread, organ-confined tumors (T1-2N0M0) increased and distant metastasis decreased. Histologically, the clear cell type made up the greatest proportion, about 90% in each period, but subtypes besides the clear cell type increased over the study period. The rate of nephron-sparing surgery increased, and exophytic masses were the most common.
CONCLUSIONS
Our review of the recent 25 year's worth of data on RCC from Seoul St. Mary's Hospital showed that the incidental diagnosis of RCC increased over the study period in accordance with the development of screening tests. Tumor size decreased in accordance with the progress in imaging modalities. In the future, multicenter research will be needed to analyze the characteristics of whole renal cancer in Korea.

Keyword

Histology; Neoplasm staging; Renal cell carcinoma

MeSH Terms

Carcinoma, Renal Cell
Humans
Kidney Neoplasms
Korea
Mass Screening
Medical Records
Neoplasm Metastasis
Neoplasm Staging
Retrospective Studies

Figure

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  FIG. 1 Age distribution of the entire group of patients studied.

Reference

1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010. 60:277–300.

2. Ministry for health, welfare and family affairs. Annual report of cancer incidence (2007), cancer prevalence (2007) and survival (1993-2007) in Korea. 2009.

3. Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr. Rising incidence of renal cell cancer in the United States. JAMA. 1999. 281:1628–1631.

4. Hock LM, Lynch J, Balaji KC. Increasing incidence of all stages of kidney cancer in the last 2 decades in the United States: an analysis of surveillance, epidemiology and end results program data. J Urol. 2002. 167:57–60.

5. Kim WJ, Chung JI, Hong JH, Kim CS, Jung SI, Yoon DK. Epidemiological study for urologic cancer in Korea (1998-2002). Korean J Urol. 2004. 45:1081–1088.

6. Green FL, Page DL, Fleming ID, Fritz A, Balch CM, Haller DG, et al. AJCC cancer staging manual. 2002. 6th ed. New York: Springer-Verlag;323–328.

7. Athar U, Gentile TC. Treatment options for metastatic renal cell carcinoma: a review. Can J Urol. 2008. 15:3954–3966.

8. Eggener SE, Yossepowitch O, Pettus JA, Snyder ME, Motzer RJ, Russo P. Renal cell carcinoma recurrence after nephrectomy for localized disease: predicting survival from time of recurrence. J Clin Oncol. 2006. 24:3101–3106.

9. Sunela KL, Kataja MJ, Kellokumpu-Lehtinen PL. Changes in symptoms of renal cell carcinoma over four decades. BJU Int. 2010. 106:649–653.

10. Beisland C, Medby PC, Beisland HO. Renal cell carcinoma: gender difference in incidental detection and cancer-specific survival. Scand J Urol Nephrol. 2002. 36:414–418.

11. Porena M, Vespasiani G, Rosi P, Costantini E, Virgili G, Mearini E, et al. Incidentally detected renal cell carcinoma: role of ultrasonography. J Clin Ultrasound. 1992. 20:395–400.

12. Thompson IM, Peek M. Improvement in survival of patients with renal cell carcinoma--the role of the serendipitously detected tumor. J Urol. 1988. 140:487–490.

13. Luciani LG, Cestari R, Tallarigo C. Incidental renal cell carcinoma-age and stage characterization and clinical implications: study of 1092 patients (1982-1997). Urology. 2000. 56:58–62.

14. Patard JJ, Tazi H, Bensalah K, Rodriguez A, Vincendeau S, Rioux-Leclercq N, et al. The changing evolution of renal tumours: a single center experience over a two-decade period. Eur Urol. 2004. 45:490–493.

15. Nguyen MM, Gill IS, Ellison LM. The evolving presentation of renal carcinoma in the United States: trends from the Surveillance, Epidemiology, and End Results program. J Urol. 2006. 176:2397–2400.

16. Flaherty KT, Fuchs CS, Colditz GA, Stampfer MJ, Speizer FE, Willett WC, et al. A prospective study of body mass index, hypertension, and smoking and the risk of renal cell carcinoma (United States). Cancer Causes Control. 2005. 16:1099–1106.

17. Chow WH, Gridley G, Fraumeni JF Jr, Järvholm B. Obesity, hypertension, and the risk of kidney cancer in men. N Engl J Med. 2000. 343:1305–1311.

18. Dhôte R, Pellicer-Coeuret M, Thiounn N, Debré B, Vidal-Trecan G. Risk factors for adult renal cell carcinoma: a systematic review and implications for prevention. BJU Int. 2000. 86:20–27.

19. Herr HW. Partial nephrectomy for incidental renal cell carcinoma. Br J Urol. 1994. 74:431–433.

20. Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H. Solid renal tumors: an analysis of pathological features related to tumor size. J Urol. 2003. 170:2217–2220.

21. Gudbjartsson T, Thoroddsen A, Petursdottir V, Hardarson S, Magnusson J, Einarsson GV. Effect of incidental detection for survival of patients with renal cell carcinoma: results of population-based study of 701 patients. Urology. 2005. 66:1186–1191.

22. Kaelin WG Jr. The von Hippel-Lindau tumor suppressor gene and kidney cancer. Clin Cancer Res. 2004. 10:6290S–6295S.

23. Escudier B, Eisen T, Stadler WM, Szczylik C, Oudard S, Siebels M, et al. Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med. 2007. 356:125–134.

24. Golimbu M, Joshi P, Sperber A, Tessler A, Al-Askari S, Morales P. Renal cell carcinoma: survival and prognostic factors. Urology. 1986. 27:291–301.

25. Cheville JC, Lohse CM, Zincke H, Weaver H, Blute ML. Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma. Am J Surg Pathol. 2003. 27:612–624.

26. Patard JJ, Leray E, Rioux-Leclercq N, Cindolo L, Ficarra V, Zisman A, et al. Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol. 2005. 23:2763–2771.

27. Kim JM, Song PH, Kim HT, Park TC. The prognostic factors for patients with pT1a renal cell carcinoma. Korean J Urol. 2010. 51:233–238.