[977] Clinicopathologic Features and Types of Surgical Resection of Renal Cell Carcinoma: Experience from a Single Tertiary Hospital in 18 Years

SS Shen, LD Truong, JY Ro, RE Link, SP Lerner, AG Ayala. The Methodist Hospital and Weill Medical College of Cornell University, Houston, TX; Baylor College of Medicine, Houston, TX

Background: The incidence of renal cancer has been rising over the last two decades with increased extirpative surgery due to widespread using of imaging modalities. In this study, we reviewed and compared the clinicopathologic features and mode of surgical resections of renal neoplasms at a single hospital over a period of 18 years.
Design: We reviewed the clinicopathologic features of 1280 renal neoplasms operated at Our hospital from 1990 to 2007. Renal urothelial carcinomas were excluded from the study. Tumor histologic subtypes were classified based on 2004 WHO classification system and staged based on 2002 AJCC staging manual. The cases were divided into three periods: 1990-1998, 1999-2003, and 2004-2007.
Results: Of the 1280 patients, 768 were male and 512 were female with an average age of 60.6 years. 121 (9.5%) and 1159 (91.5%) were benign and malignant (renal cell carcinoma, RCC) neoplasms, respectively. The benign neoplasms accounted for 4.7%, 8.6%, and 14.1% of all renal neoplasm in periods 90-98, 99-03, and 04-07, respectively. Among the RCCs, there was a lower percentage clear cell RCC, and higher percentage of papillary and chromophobe RCC from 1990 to 2007 (see Table).

Histologic Subtypes of RCC and Period of Time
Years (# Cases)Clear Cell RCCPapillary RCCChromophobe RCCCollecting Duct CarcinomaUnclassified RCC
90-98 (N=362)304 (84.0%)44 (12.2%)10 (2.8%)2 (0.6%)2 (0.6%)
99-03 (n=400)302 (76.8%)58 (14.5%)24 (6.0%)2 (0.5%)9 (2.3%)
04-07 (397)283 (71.3%)78 (19.7%)31 (7.8%)1 (0.3%)4 (1.0%)


The average sizes of RCCs were 6.2, 5.7 and 5.3 cm, and local advanced RCCs (T3/T4) accounted for 34.3%, 28%, and 26.7% of all RCCs in the periods of 90-98, 99-03, and 04-07, respectively (p<0.05). For the surgical resections of RCCs, partial nephrectomies were performed more frequently in recent years from 12.2%, to 20.8% and 28.5% in periods 90-98, 99-03, and 04-07, respectively.
Conclusions: Compared to the earlier period, in the recent years, there were increasing numbers of benign renal neoplasms treated by surgical resections; there were higher percentage of papillary and chromophobe RCCs; more small tumors and lower staged RCCs were treated by surgical resections; and partial nephrectomy has became more frequently used surgical modality.
Category: Genitourinary (including renal tumors)

Tuesday, March 23, 2010 9:30 AM

Poster Session III # 149, Tuesday Morning

 

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