The Influence of Some Epidemiological Factors and Clinical Presentation in the Survival of the Patients Diagnosed with pT1-T3 Renal Cell Carcinoma

Background According to the European Network of Cancer Registries. Eurocim version 4.0, Renal Cell Carcinoma (RCC) is the most lethal genitourinary malignancy (1), with approximately 40 % of the patients dying of metastatic disease progression (2). Based on, Cancer incidence and mortality patterns in Europe estimates for 40 countries, in 2012 there were approximately 84, 400 new cases of RCC and 34, 700 kidney cancer-related deaths in the European Union (3). In Europe, overall mortality rates for RCC increased up to the early 1990s, and stabilized or declined thereafter. However, in some European countries (Croatia, Estonia, Greece, Ireland, Slovakia), mortality rates still show an upward trend (4). Although there have been improvement in detection and treatment, there are still some uncertainties regarding the influence of some factors in the prognosis of the disease. Objectives We evaluate how signs and symptoms altogether with some epidemiological factors such as hematuria, flank pain, palpable tumor mass, thrombocytosis, haemoglobin level, erythrosedimentation rate (ESR), arterial hypertension (ATH), incidental diagnosis, smoking and gender influence in the prognosis of the patients diagnosed with Renal Cell Carcinoma, and treated with radical nephrectomy. Material and methods Between January 2009 and January 2011, 123 patients were diagnosed with kidney tumors, out of them 96 patients were diagnosed with RCC, and were treated with Radical Nephrectomy at the Urology Service, University Hospital Center Mother Teresa, Tirana, Albania. All patients included in the study were followed for up to 48 months. The duration of the follow- up was calculated from the date of the surgery to the death date or the last follow-up. The Kaplan-Meier analyzes, Cox model, and Log-rank test were used to calculate the mean survival time. Results Out of a total of 123 patients with renal tumor, only 96 patients were diagnosed with RCC, and enter the study. The mean age of the patients was 59.5.611.24 years (range 31-80yr), and male to female ratio was 1.281. The mean time of the follow-up was 44.6 1.3 months (range 12-48 months). Fifty patients (52.1 %) were diagnosed incidentally, during abdominal imaging examinations for other reasons. Only 6 patients (6.2 %) had the classic triad (palpable renal mass + hematuria + flank pain) at the moment of diagnosis. Flank pain was the most frequent symptom, followed by hematuria, and palpable tumor mass (62.5 %, 39.5 %, 10.4 % respectively). Follow-up time included in the study varied from 12 month to 48 months. During follow-up period 10 patients (10.4 %) died from RCC.