Login to Access Video or Poster Abstract: MP72-02
Sources of Funding: None

Introduction

We aimed to define the clinical features of renal cell carcinoma (RCC) arising in patients with end-stage renal disease (ESRD).

Methods

A total of 261 patients (male, n=221; female, n=40; median age, 56 years; range 21 - 81 years) with ESRD and RCC who underwent radical nephrectomy at our institute between November 1985 and June 2016. The dialysis status of all patients at the time of diagnosis was chronic renal failure. Information was collected about age, sex, symptoms, duration of dialysis therapy, tumor staging and grading, histological subtype and outcome, and the median post-surgical follow up was 78 (range 1 - 368) months.

Results

The median duration of dialysis before surgery was 146 (range 1 - 400) months. Symptomatic RCC was evident in 24 (9.1%) patients, and gross hematuria was the most frequent complaint (12 patients). Renal cell carcinoma was incidentally diagnosed in 237 (90.9%) patients by ultrasonography or computed tomography screening. Bilateral RCC was observed in 56 patients (21%). Thus, radical nephrectomy was performed in 317 kidneys. Mean maximum tumor size was 2.45 cm. Organ-confined cancer was pathologically proven after radical nephrectomy in 98% of the patients, including 86% of those with pT1 (tumors < 7cm). Only four patients had advanced RCC (pT3). The histological subtypes were clear cell, papillary in 76 (24%) and dialysis-related renal tumors in 233 (74%), 76 (24%) and 8 (3%) patients, respectively. Three patients died of renal cancer and 31 died due to other causes. The estimated 5- and 10-year overall survival rates were 95% and 89%, respectively. Especially, the estimated 5- and 10-year cancer-specific survival rates were both 98.8%.

Conclusions

Long-term outcomes for patients with RCC and ESRD were favorable in this study. Therefore, the early detection of tumors is particularly important for the optimal survival of patients with RCC and ESRD. This can be achieved through regular monitoring by abdominal ultrasonography or computed tomography.

Funding

None