Klin Onkol 2002; 15(2): 64-66.
Summary:
Background: By applying advanced imaging modalities (USG, CT), occurence of incidentally detected renal cell carcinoma (RCC) that can be diagnosed in preclinical stage, has increased. The aim of the study is to determine mode of presentation of RCC, the effect of early diagnosis on choice of treatment and patients survival.
Design and subject: In the retrospective study the documentation of 196 patients with RCC treated in the period 1996-2000 was reviewed.
Methods and Results: Patients were divided in two goups by the mode of presentation of RCC: Group 1 patients with RCC diagnosed on bases of urological and paraneoplastic symptoms, and symptoms of metastatic disease; Group 2 patients with incidentally detected RCC. Both groups were compared by characteristics of patients and characteristic of tumour. The results of this study were compared with the results of patients treated during 1981-1995. Mode of manifestation of RCC: urological symptoms 57 (29.1 %), paraneoplastic symptoms 12 (6.1 %), symptoms from metastases 6 (3.1 %) and incidental RCC in 121 (61.7 %) of patients. Histologically RCC was found in the following clinical stages: T1 84 (42.9 %), T2 29 (14.8 %), T3 77 (39.3 %) and T4 6 (3.1 %). At the time of diagnosis the metastases were present in 26 (13.3 %) patients.
Treatment: 187 (95.4 %) patients underwent radical nephrectomy, 4 (2 %) partial nephrectomy and 5 (2.6 %) probatory laparotomy. In patients with incidental RCC most common reasons for applying advanced imaging methods were gastrointestinal 30 (24.8 %), cardiovascular 27 (22.3 %) and urological 26 (21.5 %) diseases. Imaging methods used for diagnosis of incidental RCC were USG 113 (93,4 %), CT 6 (5 %) and others 2 (1.7 %).
Conclusions: RCC was incidentally diagnosed in 61.7 % patients. 81 (41.3 %) patients had the tumour in stage T1 NX MO. Shift into earlier stages of RCC has not yet affected the mode of treatment, but the mortality from RCC in Slovakia has decreased.
