Abstract
BackgroundThere are global differences in the incidence, stage, prognosis, pathological profile and presentation of renal cell carcinoma (RCC). We review and describe the risk factors, pathological profile, stage and epidemiology of RCC in a South African centre. Prospective data were collected from all patients undergoing partial or radical nephrectomy for suspected RCC from July 2016 to March 2018.ResultsWe collected data from 35 patients and excluded four patients after histological examination showed benign disease. The most common mode of presentation was incidental finding in 48%; with only one case presenting with the classical triad of abdominal mass, flank pain and macroscopic haematuria. The pathological profile of RCC cases included: clear cell 23 (74%), papillary type II 5 (16%), papillary mixed type I and II 1 (3%) and chromophobe 2 (7%). The pathological stage of the patients varied, from pT1a to pT3b. The median stage of presentation was pT1b. There was a trend towards a more advanced stage with the presence of obesity, female gender, smoking and hypertension.ConclusionThe pathological profile and presenting symptoms in our population mimics that seen in Europe and the USA, with the exception of an increased prevalence of papillary type II RCC. The stage and presenting symptoms differ from that seen in other African studies, whilst our population followed the trend of younger presentation seen elsewhere in Africa.
Highlights
There are global differences in the incidence, stage, prognosis, pathological profile and presentation of renal cell carcinoma (RCC)
We evaluated if the presence of known risk factors for RCC translates into a more advanced stage at presentation, or a higher International Society of Urologic Pathologists (ISUP) grade
3 Results There were 35 patients who presented with suspected RCC on diagnostic radiology between July 2016 and March 2018
Summary
There are global differences in the incidence, stage, prognosis, pathological profile and presentation of renal cell carcinoma (RCC). We review and describe the risk factors, pathological profile, stage and epidemiology of RCC in a South African centre. Little information exists regarding the epidemiology of renal cell carcinoma (RCC) in South Africa, or Africa [1]. There are global disparities in the incidence of RCC, with a higher incidence in Europe and North America and a lower incidence in Asia and South America [2]. There are known population group and gender disparities with regards to stage at presentation and prognosis of RCC. Studies from the USA have shown a significantly increased incidence of RCC and lower associated survival. Incidental discovery is the most likely presentation of RCC in much of the world, with 82% of masses less than 4 cm and 56% of those greater
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