Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Clinicopathologic Patterns of Adult Renal Tumors in Pakistan

  • Hashmi, Atif Ali (Department of Histopathology, Liaquat National Hospital and Medical College) ;
  • Ali, Rabia (Department of Histopathology, Liaquat National Hospital and Medical College) ;
  • Hussain, Zubaida Fida (Department of Histopathology, Liaquat National Hospital and Medical College) ;
  • Faridi, Naveen (Department of Histopathology, Liaquat National Hospital and Medical College)
  • Published : 2014.03.01
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Abstract

Background: Renal cancer is a serious public health problem which may be under reported and registered in our setup, since the Karachi cancer registry documented only 43 cases out of 4,268 incident cancer cases over 3 year duration. Therefore we aimed to determine the clinicopathologic characteristics of adult renal tumors in our setup. Materials and Methods: The study was conducted in histopathology department, Liaquat National Hospital and included total of 68 cases of adult renal tumors over 4 years. Detailed histopathologic characteristics of tumors were analyzed. Results: Mean age of patients was 56.4 (18-84) years. Renal cell carcinoma (RCC) was the most common cell type (78%) cases; followed by transitional/urothelial carcinoma (12.5%), leiomyosarcoma (4.7%), oncocytoma (1.6%), squamous cell carcinoma (1.6%) and high grade pleomorphic undifferentiated sarcoma (1.6%). Among 50 RCC cases; 62% were conventional/clear cell RCC (CCRCC) type followed by papillary RCC(PRCC), 24%; chromophobe RCC(CRCC), 6% and sarcomatoid RCC(SRCC), 8%. Mean tumor size for RCC was 7.2 cm. Most RCCs were intermediate to high grade (60% and 40% respectively). Capsular invasion, renal sinus invasion, adrenal gland involvement and renal vein invasion was seen in 40%, 18%, 2% and 10% of cases respectively. Conclusions: We found that RCC presents at an earlier age in our setup compared to Western populations. Tumor size was significantly larger and most of the tumors were of intermediate to high grade. This reflects late presentation of patients after disease progression which necessitates effective measures to be taken in primary care setup to diagnose this disease at an early stage.

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References

  1. Abel EJ, Carrasco A, Karam J, et al (2013). Positive vascular wall margins have minimal impact on cancer outcomes in non-metastatic RCC patients with tumor thrombus. BJU Int, 10, 1111.
  2. Amin MB, Tamboli P, Javidan J, et al (2002). Prognostic impact of histologic subtyping of adult epithelial neoplasms, An experience of 405 cases. Am J SurgPathol, 26, 281-91.
  3. Anderson CB, Clark PE, Morgan TM, et al (2011). Urinary collecting system invasion is a predictor for overall and disease-specific survival in locally invasive renal cell carcinoma. Urology, 78, 99-104. https://doi.org/10.1016/j.urology.2011.02.039
  4. Atkins MB(2005). Management of advanced renal cancer. Kidney Int, 67, 2096.
  5. Bocardo Fajardo G, Arnellano GerianR, Gonzelez Lopez L, et al (2009). Prognostic significance of the microscopic invasion of renal vein wall in RCC. Arch Esp Urol, 62, 630-8.
  6. Bhurgri Y, Bhurgri A, Hassan SH, et al (2000). Cancer incidence in Karachi, Pakistan, first result from Karachi Cancer Registry. Int J Cancer, 85, 325-9. https://doi.org/10.1002/(SICI)1097-0215(20000201)85:3<325::AID-IJC5>3.0.CO;2-J
  7. Chow WH, Dong LM, Devesa SS (2010). Epidemiology and risk factors for kidney cancers. Nat Rev Urol, 7, 245. https://doi.org/10.1038/nrurol.2010.46
  8. Chow WH, Gridley G, Fraumeni JF Jr, Jarvholm B (2000). Obesity, hypertension and the risk of kidney cancer in men. N Engl J Med, 343, 1305. https://doi.org/10.1056/NEJM200011023431804
  9. Coppin C, Porzsolt F, Awa A, et al (2005). Immunotherapy for advanced renal cell cancer. Cochrane Database Syst Rev, 1425.
  10. Delahunt B, Sika-Paotonu D, Bethwaite PB, et al (2011). Grading of clear cell renal cell carcinoma should be based on nucleolar prominence. Am J Surj Pathol, 35, 1134-9. https://doi.org/10.1097/PAS.0b013e318220697f
  11. Delahunt B, Sika-Paotonu D, Bethwaite PB, et al (2007). Fuhrman grading is not appropriate for chromophobe renal cell carcinoma. Am J Surg Pathol, 31, 957-60. https://doi.org/10.1097/01.pas.0000249446.28713.53
  12. Gunes M, Gecit I, Pirincci N, Taken K, Ceylan K (2012). Nature of lesions undergoing radical nephrectomy for renal cancer. Asian Pac J Cancer Prev, 114, 101.
  13. Hank R, Bui MH, Pantuck AJ, et al (2003). TNM T3a renal cell carcinoma, Adrenal gland is not the same as renal fat invasion. J Urol, 169, 899-3. https://doi.org/10.1097/01.ju.0000051480.62175.35
  14. Hunt JD, van der Hel OL, McMillan GP, et al (2005). Renal cell carcinoma in relation to cigarette smoking, a meta-analysis of 24 studies. Int J Cancer, 114, 101. https://doi.org/10.1002/ijc.20618
  15. Hyuk-Jin Cho, Su Jin Kim, U-Syn Ha, et al (2009). Prognostic Value of Capsular Invasion for Localized Clear-Cell Renal Cell Carcinoma, Eur Urol, 56, 1006-12. https://doi.org/10.1016/j.eururo.2008.11.031
  16. Jeong IG, Jeong CW, Hong SK, et al (2006). Prognostic implication of capsular invasion without perinephric fat infiltration in localized renal cell carcinoma. Urology, 67, 709-12. https://doi.org/10.1016/j.urology.2005.10.042
  17. Jonasch In, Kantarjian HM, Wolff RA, Koller CA (2006). Renal cell carcinoma. MD Anderson Manual of Medical Oncology. New York NY, McGraw-Hill.
  18. Kato M, Suzuki T, Suzuki Y, et al (2004). Natural history of small renal cell carcinoma, evaluation of growth rate, histological grade, cell proliferation and apoptosis. J Urol, 172, 863-6. https://doi.org/10.1097/01.ju.0000136315.80057.99
  19. Kane CJ, Mallin K, Ritchey J, et al (2008). Renal cell cancer stage migration, Analysis of the National Cancer Database. Cancer, 113, 78-83. https://doi.org/10.1002/cncr.23518
  20. Kobayashi T, Nakamura E,Vamamoto S, et al (2003). Low incidence of ipsilateral adrenal involvement and recurrence in patients with renal cell carcinoma undergoing radical nephrectomy, A retrospective analysis of 393 patients. Urology, 62, 40-5.
  21. Latif F, Mubarak M, Kazi (2011). Histopathological characteristics of adult renal tumours, a preliminary report. J Pak Med Assoc, 61, 224-8.
  22. LeibovichBC, Lohse CM, Crispen PL, et al (2010). Histological subtype is an independent predictor of outcome for patients with renal cell carcinoma. J Urol, 183, 1309-15. https://doi.org/10.1016/j.juro.2009.12.035
  23. Linehan MW, Berton Z, Bates S, et al (2001). Cancer of kidney and ureter. Principles and Practice of Oncology. 6th ed. Philadelphia, Pa, Lippincott Williams and Wilkins, 1362-96.
  24. Ljungberg B, Campbell SC, Choi HY, et al (2011). The epidemiology of renal cell carcinoma. Eur Urol, 60, 615. https://doi.org/10.1016/j.eururo.2011.06.049
  25. Minervani A, Rosaria Raspollini M, Tuccio A, et al (2014). Pathological characteristic and prognostic effect of peritumoral capsule penetration in renal cell carcinoma after tumor enucleation. Urol Oncol, 32, 15-2.
  26. Motzer RJ, Bacik J, Mariani T, et al (2000). Treatment outcomes and survival associated with metastatic renal cell carcinoma of non-clear-cell histology. J Clin Oncol, 20, 2376.
  27. Murphy WM, GrignonDJ, Perlman EJ, et al (2004). Tumors of thkidney, Bladder and related urinary structures. AFIP. Fourth series, Fascicles 1. Washington DC, 2004. P.101-24039.
  28. Patard JJ, Leray E, Rioux-Leclercq N, et al (2005). Prognostic value of histologic subtypes in renal cell carcinoma, a multicenter experience. J Clin Oncol, 23, 2763-7124.
  29. Purdue MP,Moore LE,Merino MJ, et al (2013). An investigation of risk factors for renal cell carcinoma by histologic subtype in two case-control studies. Int J Cancer, 132, 2640-7. https://doi.org/10.1002/ijc.27934
  30. Reddy N B, Reddy K N, MadithatiP, et al (2012). A study of the epidemiologic distribution of renal tumors in Tirupati, Andhra Pradesh. J NTR Univ Health Sci, 1, 217-21. https://doi.org/10.4103/2277-8632.105105
  31. Rioux-Leclercq N, Karakiewicz PI, Trinh QD, et al (2007). Prognostic ability of simplified nuclear grading of renal cell carcinoma. Cancer, 109, 868-74. https://doi.org/10.1002/cncr.22463
  32. Sankin A, Cohen J,Wang H, Macchia RJ, Karanikolas N (2011). Rate of renal cell carcinoma subtypes in different races. Int Braz J Urol, 37, 29-2. https://doi.org/10.1590/S1677-55382011000100004
  33. Sidana A, Goyal J, Aggarwal P, et al (2012). Determinants of outcomes after resection of renal cell carcinoma with venous involvement. Int Urol Nephrol, 44, 1671-9. https://doi.org/10.1007/s11255-012-0314-x
  34. Siegal R, Naishadham D, Jemal A (2012). Cancer Statistic. CA Cancer J Clin, 62, 10. https://doi.org/10.3322/caac.20138
  35. Siegal R, Naishadham D, Jemal A (2013). Cancer Statistic. CA Cancer J Clin, 63, 11. https://doi.org/10.3322/caac.21166
  36. Siener S, Lehman J, Loch A, et al (2005). Current TNM classification of renal cell carcinoma evaluated, Revising Stage T3a. J Urol, 173, 33-7. https://doi.org/10.1097/01.ju.0000146719.43269.e8
  37. Sika-Paotonu D, Bethwaite PB, McCredie MR, et al (2006). Nucleolar grade but not Fuhrman grade is applicable to papillary renal cell carcinoma. Am J Surg Pathol, 30, 1091-6.
  38. Suer E, Ergun G, Baltaci S, Beduk Y (2008). Does renal capsular invasionhave any prognostic value in localized renal cell carcinoma? J Urol, 180, 68-71. https://doi.org/10.1016/j.juro.2008.03.060
  39. Srivasta A, Mandhani A, Kapoor R, et al (2004). Prognostic factors in renal cell carcinoma, is TNM (1997) staging relevant in Indian subpopulation? Indian J Cancer, 41, 99-103.
  40. Talic FR, El Faqih SR (1996). Renal tumors in adult Saudi patients, A review of 43cases. Ann Saudi Med, 16, 517-20.
  41. Teloken PE, Thompson RH, Tickoo SK, et al (2009). Prognostic impact of histologic subtype on surgically treated localized renal cell carcinoma. J Urol, 182, 2132-6. https://doi.org/10.1016/j.juro.2009.07.019
  42. Terrone C, Cracco C, Guercio S, et al (2004). Prognostic value of the involvement of urine collecting system in renal cell carcinoma. Eur Urology, 46, 472-6. https://doi.org/10.1016/j.eururo.2004.07.006
  43. Thompson RH, Ordonez MA, Iasonos A, et al (2008). Renal Cell Carcinoma in young and old patients is there a difference ? J Urol, 180, 1262-6. https://doi.org/10.1016/j.juro.2008.06.037
  44. Tsui KH, Shvarts O, Smith RB, et al (2000). Prognostic indicators for renal cell carcinoma, a multivariate analysis of 643 patients using the revised 1997 TNM staging criteria. J Urol, 163, 1090-5. https://doi.org/10.1016/S0022-5347(05)67699-9
  45. Upton MP, Parker RA, Youmans A, et al (2005). Histological predictors of renal cell carcinoma response to interleukin-2 based therapy. J Immunother, 114, 101.
  46. Wang R, Wolf JS Jr, Wood DP Jr, Higgins EJ, Hafex KS(2009). Accuracy of percutaneous core biopsy in management of small renal masses. Urology, 73, 586-90. https://doi.org/10.1016/j.urology.2008.08.519
  47. Zhang C, Li X, Hao H, et al (2012). The correlation between size of renal cell carcinoma and its histopathological characteristics, a single center study of 1867 renal cell carcinoma cases. BJU Int, 110, 481-5. https://doi.org/10.1111/j.1464-410X.2012.11173.x

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