Rise in Localized High-Risk RCC Reported

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Over a 25-year period, the proportion of patients with high-risk clinical T1 tumors increased by nearly 20% and clinical tumor size decreased from 8.4 to 6.2 cm, an Italian study found.
Over a 25-year period, the proportion of patients with high-risk clinical T1 tumors increased by nearly 20% and clinical tumor size decreased from 8.4 to 6.2 cm, an Italian study found.

Investigators who examined trends in the clinical characteristics of pathologically-confirmed high-risk renal cell carcinoma (RCC) over a 25-year period found that patients are being diagnosed at an older age and the size of their tumors has decreased.

In addition, the proportion of asymptomatic patients at diagnosis has increased.

A team led by Umberto Capitanio, MD, of IRCCS San Raffaele Scientific Institute in Milan, Italy, studied 741 patients with pathologically-confirmed high-risk RCC (pT1–4 and/or pN1 and/or Fuhrman grade 3–4 and/or al M1 patients). All underwent radical or partial nephrectomy at a single tertiary referral center from 1987 to 2011.

During this period, the median age of patients increased from 57.5 to 67.3 years, the investigators reported in Anticancer Research 2018;38:4123-4130). Clinical tumor size declined from 8.4 to 6.2 cm. The proportion of patients with clinical T1 tumors and those with asymptomatic cancer at diagnosis increased by 19.8% and 41.1%, respectively. Meanwhile, the rate of patients without clinical metastases increased by 15.3%.

Results also showed that the rate of partial nephrectomies (PN) performed increased by 23.3%. The rate of clinical lymphadenopathies remained stable over time, according to the investigators.

“These trends can explain the increasing number of PNs performed despite the presence of a high-risk cancer profile,” the authors noted.

REFERENCE

DI Trapani E, Dell'oglio P, Larcher A, et al. Pathological high-risk renal cell carcinoma: Trends in Clinical Characteristics over 25 years. Anticancer Res. 2018;38:4123-4130.

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