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OVERTON BROOKS VAMC PRELIMINARY FINDINGS IN PATIENTS EXPOSED TO AGENT ORANGE WITH RENAL CELL CANCER

Login to Access Video or Poster Abstract: 529
Date & Time: May 15, 2011 03:30 PM
Session Title: Kidney Cancer: Evaluation and Staging
Sources of Funding: Source of Funding: None

INTRODUCTION AND OBJECTIVES:
The effect of Agent Orange (AO) on the human body has remained a topic of controversy in medical literature over the last forty years. Previous studies have documented increased risks of several different cancers in those exposed. There have been no studies to date reviewing renal cell cancer in patients exposed to AO. The purpose of this study was to review the characteristics of renal cell cancer in patients exposed to Agent Orange.

METHODS:
A retrospective chart review was performed from 1987 to 2009 of all patients diagnosed with renal cell cancer (RCC) at Overton Brooks VAMC in Shreveport, Louisiana. We specifically reviewed age of presentation, tumor size, side of lesion, pathology and survival in patients with documented exposure to AO.

RESULTS:
297 patients were diagnosed with renal cell cancer over a period of 22 years. Thirteen patients (4%) claimed exposure to Agent Orange. The average age of presentation was 56.5 years (range 39-63). Eleven of the 13 AO patients were treated surgically. Of these 11 patients treated surgically, nine presented with T1 lesions; one with T2. Six lesions were left sided. Size ranged from 2.5-5.5 cm in the T1 group. The T2 lesion measured 12cm. Pathology was clear cell in eight, combined clear cell and papillary in one, and pure papillary in one. Pathology was unavailable in one patient. Three had nodal sampling at the time of surgery including the patient with T2 disease, and all nodes sampled were negative. Mean follow-up was 54 months (range 4-168). Four patients developed metastatic disease. Their mean age was 50.3 years (range 39-59). One patient died of his disease. Of the remaining two patients, one died of concurrent large cell lymphoma and the other of perforated diverticulitis.

CONCLUSIONS:
40% of the patients exposed to AO progressed to metastatic disease and in a population with an average age of 50. Further data is being collected from other VA medical centers to further investigate if there is a link between renal cell cancer and Agent Orange exposure.
Authors
Schmeeckle, Ayme; Moore, Deborah; Moore, Robert; Hadaad, Phillip 
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