Pathological High-risk Renal Cell Carcinoma: Trends in Clinical Characteristics Over 25 Years
The incidence of renal cell carcinoma (RCC) has been increasing mainly due to the increase in the incidental detection of small renal masses during US and CT scan. The aim of this study was to verify whether the trend towards early diagnosis changed the clinical characteristics of pathologically-defined high-risk RCC patients over the last decades.
The authors studied 741 patients with pathologically-confirmed high-risk RCC. All underwent radical or partial nephrectomy at a single tertiary referral center from 1987 to 2011.
During this period, the median age of patients increased from 57.5 to 67.3 years, the investigators reported in Anticancer Research 2018;38:4123-4130). Clinical tumor size declined from 8.4 to 6.2 cm. The proportion of patients with clinical T1 tumors and those with asymptomatic cancer at diagnosis increased by 19.8% and 41.1%, respectively. Meanwhile, the rate of patients without clinical metastases increased by 15.3%.
Over the years, pathologically-confirmed high-risk RCC patients are older, mostly asymptomatic, with smaller cancers, with a higher rate of tumors localized to the kidney and with a decreased rate of metastatic disease at diagnosis. These trends can explain the increasing number of PNs performed despite the presence of a high-risk cancer profile.
DI Trapani E, Dell'oglio P, Larcher A, et al. Pathological high-risk renal cell carcinoma: Trends in Clinical Characteristics over 25 years. Anticancer Res. 2018;38:4123-4130.