Pathological features of incidental and symptomatic renal cell carcinoma

Abstract

Objective: Incidental renal cell carcinoma (RCC) cases is increasing significantly. This study compared the pathologic features of incidental and symptomatic RCC cases. Materials and methods: The study divided 114 patients undergoing nephrectomy into two groups: incidental (64 cases) and symptomatic (50 cases) RCC. Patient age, gender, tumor size, histological sub-type, TNM stage, Fuhrman grade, and survival time were determined. Results: The male/female (78/36) ratio was 2.1 and no difference was observed between groups (p=0.8793). For incidental and symptomatic cases, the mean patient age was 55.5±6.4 vs. 58.8±4.7 years (p=0.0028), respectively; tumor diameter was 4.8±1.8 vs. 6.7±1.5 cm (p<0.0001); the mean follow-up was 73.8±17.3 vs. 71.3±14.7 months (p=0.4157); and the mean survival time was 64.7±22.5 vs. 53.5±18.7 months (p=0.0054). There were 48 (75%), 14 (21.8%), 2 (3.1%), and 0 (0%) pT1, pT2, pT3, and pT4 tumors, respectively, for incidental cases, and 16 (32%), 18 (36%), 14 (28%), and 2 (4%) for symptomatic cases (p=0.0024, p=0.0572, p=0004, and p=0.1096 for pT1, pT2, pT3, and pT4, respectively). There were 20 (40%) lymphatic metastases in symptomatic cases and 4 (6.2%) in incidental cases (p=0.0121 and p=0.0014 for N1 and N2). No patient had distant organ metastases. There were no significant differences between groups in terms of histopathological subtype or Fuhrman grade. Conclusion: Incidental RCC is diagnosed in the early phase, and has better prognostic factors than symptomatic cases in terms of tumor size and stage.