Clinical features and Histological subtypes of RCC. Single center experience


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Faisal Azam1,Waleed Mohammed Al Selwi2,Samir Taha Fotih2,Osama Zeid Abduljalil2,Ahmed Mohammed Wbari2,Fahad Ibnshamsah2,Faisal Azam2
1King Fahad Specialist Hospital,2King Fahad Specialist Hospital, Dammam

Abstract

Background

Renal cell carcinoma (RCC) commonly occurs in elderly with a median age at diagnosis of ≥ 65 years. Clear cell is the most common histological type followed by pappilary carcinoma. The present study is aimed at reviewing the main clinical and histological RCC subtypes at our tertiary Oncology center.

Method

Retrospective review of clinical notes, electronic records and hospital cancer registry of patients (pts) with a RCC treated at a tertiary Oncology center from 2008-14.

Results

A total of 92 patients were diagnosed with RCC. Median age at diagnosis was 55 (21-96) years. It was more prevalent in males (male:female ratio 1.5:1). The most common histological types was clear cell (n=62, 67%) followed chromophobe (n=17, 19%), papillary (n=4, 4%), medullary (n=2, 2%) and other rare types in 7 patients. Sarcomatoid transformation was mentioned in 5 (5.5%) specimens. 21 (23%) patients presented with metastatic disease and another 11 patients developed recurrent metastatic disease after initial treatment for primary RCC. The main sites of metastases were lungs (n=22, 69%), liver (n=12, 38%), bones (n=11, 34%) and nervous system (n= 10, 31%). All (100%) patients with sarcomatoid differentiation had metastatic disease. 18 (30%) of 62 patients with clear cell RCC and only 1 (6%) of 17 patients with chromophobe RCC had metastatic disease. Most of the patients with metastatic disease were poor risk (n=23, 72%) at presentation followed by intermediate risk (n=8, 25%) and favourable risk (n=1) on MSKCC (memorial slain-kettering cancer center) prognostic score

Conclusion

As compared to the figures mentioned in the medical literature, median age of the patients with RCC at our center is 10 years less and Chromophobe rather than papillary subtype of RCC is the second most common type. Clear cell RCC remains the most common type. Chromophobe RCC tends to have a better prognosis and fewer tendencies for metastatic disease.