626 CONTEMPORARY CLINICAL EPIDEMIOLOGY OF RENAL CELL CARCINOMA: INSIGHT FROM THE UNITED STATES KIDNEY CANCER STUDY

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced II1 Apr 2010626 CONTEMPORARY CLINICAL EPIDEMIOLOGY OF RENAL CELL CARCINOMA: INSIGHT FROM THE UNITED STATES KIDNEY CANCER STUDY David Miller, Julie Ruterbusch, Joanne Colt, Wong-Ho Chow, and Kendra Schwartz David MillerDavid Miller Ann Arbor, MI More articles by this author , Julie RuterbuschJulie Ruterbusch Detroit, MI More articles by this author , Joanne ColtJoanne Colt Bethesda, MD More articles by this author , Wong-Ho ChowWong-Ho Chow Bethesda, MD More articles by this author , and Kendra SchwartzKendra Schwartz Detroit, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.962AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In order to clarify the contemporary clinical epidemiology of renal cell carcinoma (RCC), we describe demographic and cancer-specific characteristics of the population-based sample of patients enrolled in the National Cancer Institute's U.S. Kidney Cancer Study (KCS), and present trends in their clinical presentation and management. METHODS The KCS is a population-based case-control study conducted in metropolitan Detroit, MI and Chicago, IL from 2002 through 2007. During the study interval, 1,136 patients with kidney cancer consented to both an epidemiological interview and medical record review. We ascertained detailed information regarding patient demographics, medical history (including presenting symptoms and comorbidities), methods of RCC detection and diagnosis, clinical and pathological characteristics of the kidney cancer, and treatment(s) received. From these data, we assessed the demographic and cancer-specific characteristics of KCS cases, as well as trends in their clinical presentation, diagnosis, and treatment. RESULTS Among the analytic cohort, 951 (84%) and 185 (16%) cases accrued in the Detroit and Chicago study sites, respectively. A majority of cases were white, married, insured, and younger than 65 years at the time of kidney cancer diagnosis. Most patients had localized or regional tumors, including 52% with tumor size ≤ 4 cm. The proportion of cases with asymptomatic tumors increased from 35% in 2002 to 50% in 2007 (p< 0.001, Figure). Hypertension (58%) and diabetes (17%) were common among KCS cases, and 24% percent of patients had at least 2 significant comorbidities at the time of diagnosis. Overall, 96% of cases underwent surgical therapy for RCC. While the use of laparoscopic surgery increased over time (p < 0.001), fewer than 1 in 5 patients received nephron-sparing surgical therapy. CONCLUSIONS The proportion of patients presenting with small, asymptomatic renal cell carcinomas continued to increase during the early 21st century. Most of these patients are still treated with radical nephrectomy, although increasingly via a laparoscopic approach. Because most patients with small RCCs have one or more renal function-relevant comorbidities, there is an imperative to increase utilization of nephron-sparing surgery in this patient population. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e246 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Miller Ann Arbor, MI More articles by this author Julie Ruterbusch Detroit, MI More articles by this author Joanne Colt Bethesda, MD More articles by this author Wong-Ho Chow Bethesda, MD More articles by this author Kendra Schwartz Detroit, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...