Clinical Profile and Outcome of Patients Operated on for Renal Cell Carcinoma: Experience from a Tertiary Care Center in a Developing Country.

Abstract

With nearly 500,000 new cases and over 150,000 deaths worldwide in 2020, renal cancers remain a significant component of the global burden of cancer. The aim of this study is to describe the clinical presentation, peri-operative condition and short-term outcome of patients operated with the primary diagnosis of renal cell carcinoma (RCC) at a large tertiary care referral center. A retrospective institution-based study was done. The study population consisted of all patients who were operated for a primary diagnosis of renal cell carcinoma from January 1st, 2015, to December 31st, 2020, at the Urology Unit of St Paul's Hospital Millennium Medical College. The final cohort consisted of 107 patients (mean (standard deviation) age 49 (±14) years, 48% male, 46% residence in Addis Ababa). The most common presenting complaint was flank pain (65%), followed by hematuria (34%) and abdominal mass (6%). One patient had the classic triad of RCC. The median (IQR) duration of illness was 9(7-11) months. Fourteen (13%) patients were asymptomatic and diagnosed incidentally. Over half (57%) of the cohort were clinical TNM stage II, with the remaining 17%, 18% and 8% being stage I, III and IV, respectively. Nearly all patients (94%) underwent open radical nephrectomy with a transabdominal approach. Most patients (61%) had no Clavien-Dindo grade complications, and a minority (11%) experienced post-operative complications (7% postoperative bleeding, 6% hospital acquired pneumonia, 3% surgical site infection). The median (IQR) length of stay was 6 (5-7.6) days. Nearly all patients (94%) were discharged and improved. In this retrospective study, we have shown that patients operated for RCC are a low-risk cohort with few comorbidities, have a relatively short symptomatic course and good discharge outcome. Further prospective studies are needed to show the long-term outcome and factors associated with such outcomes in this patient population.