[997] Renal Cell Carcinoma (RCC) in Hemodialysed (HD) Patients: The Duration of Hemodialysis May Influence the Pathological Type and Prognosis

T Tsuzuki, N Sassa, M Fukatsu, T Fujita, S Katsuno, T Nishikimi, R Hattori, M Gotoh. Nagoya Daini Red Cross Hopital, Nagoya, Japan; Nagoya University, Nagoya, Japan; Komaki Municipal Hospital, Komaki, Japan; Chyukyo Hospital, Nagoya, Japan; Okazaki Municipal Hospital, Okazaki, Japan

Background: It is well established that RCC is one of the most important complications in hemodialysis patients. However, the influence of the HD duration on RCC has not been determined. Therefore, this study determined if the HD duration relates to the pathological type and prognosis.
Design: This study consisted of 69 patients on HD (73 kidneys) who underwent a radical nephrectomy for RCCs from January 1991 to December 2008. We classified the patients into three groups based on the duration of HD (Group 1: less than 10 years; Group 2: from 11 to 20 years; Group 3: over 21 years). All cases were reviewed without clinical information, and the pathological type and parameters were recorded.
Results: The patients who received HD for more than 10 years showed a distinctive distribution of the pathological type (p=0.01) and pT stage (p=0.003), as listed in Table 1.

Pathological subtype and pT stage according to the HD duration.

	Total	Group 1	Group 2	Group 3
Clear cell RCC	32	18	8	6
Papillary RCC	11	3	3	4
Sarcomatoid RCC	8	0	2	6
ACDK-associated RCC	17	2	11	5
Others	5	1	1	2
pT1a	42	18	14	10
pT1b	9	4	5	0
pT2	5	1	3	1
pT3a	11	1	3	7
pT3b	3	0	0	3
Unknown	3	0	1	2

The disease free survival (DFS) among the three groups was statistically different (p<0.05). The incidence of RCCs with sarcomatoid component was detected after 10 years of HD. The DFS of RCCs with sarcomatoid component was 55.9% and 37.3% at 5 years and 10 years, respectively.
Conclusions: The HD duration influenced the pathological type and pT stage of RCCs in HD patients. RCCs with sarcomatoid component, which led to a poor outcome, occurred after more than 10 years of HD. Therefore, it is necessary that patients who receive HD, for an extended period of time, especially more than 10 years, undergo frequent and careful medical examinations.
Category: Genitourinary (including renal tumors)

Tuesday, March 23, 2010 9:30 AM

Poster Session III # 155, Tuesday Morning