Renal cell carcinoma: the experience of Kuwait Cancer Control Center, Kuwait

This retrospective study was undertaken to analyze the profile of patients presenting with renal cell carcinoma [RCC] and treatment outcomes. Subjects and Records of 49 patients [36 male, 16 female, 21-75 years] treated at the Kuwait Cancer Control Center, Kuwait for RCC during the period 1993-1998 were analyzed. Forty-one patients had a nephrectomy, 18 postoperative radiotherapy and 1 patient also received adjuvant immunotherapy with interferon. Patients with metastatic disease were treated with a variety of agents including interferon, chemotherapy [vinblastine] or a hormonal agent [megestrol acetate]. Data analysis was performed using SPSS statistical software package. Overall survival and disease-free survival were calculated using the Kaplan-Meier method. Twenty-nine patients presented with symptoms classically associated with RCC. Metastases at diagnosis were seen in 9 patients [18%], with lung being the most frequent site. The commonest tumor subtype was clear cell carcinoma [32.6%]. Thirty-nine patients [80%] achieved a complete response to treatment and relapse was documented in 10 patients [26%]. The majority of failures were distant, with lung metastases being the most common. Response to salvage treatment was poor. Overall survival was 83% at 2 years. The disease-free survival was 68 and 45% at 2 and 5 years, respectively. Although many patients presented with advanced local disease, a majority achieved complete response after radical surgery with or without postoperative radiation therapy. Salvage of metastatic disease proved difficult with interferon, chemotherapy

Primary malignant tumors of the trachea: the Tata Memorial Hospital expeience

Primary tumors of the trachea are extremely rare. Treatment methods vary considerably and few studies have sought to provide adequate guidelines. This study reviews the records of patients treated for tracheal cancer at the Tata Memorial Hospital [TMH], Mumbai, India. Subjects and Fifteen patients with primary tracheal malignancies were identified in the TMH database during the period from 1983 to 2000. They were predominantly males [87%] belonging to an older age-group [67% above 40 years]. Common presenting symptoms were cough, hoarseness, hemoptysis and indications of airway obstruction. Squamous cell carcinoma was the commonest histologic subtype [40%] followed by adenoid cystic carcinoma [27%]. Ten patients received radical treatment. One patient underwent surgery [resection and anastomosis] and received postoperative radiotherapy. Another was explored but was found to be unresectable and was 1 of 2 patients treated with chemotherapy and radiotherapy. Laser resections and radiotherapy were used in 2 patients while 4 patients were managed with radiotherapy alone. One patient was treated elsewhere. The majority of patients [8/9] were treated with locoregional fields and doses ranging from 40 to 60 Gy [median 50 Gy]. Two patients also received intraluminal brachytherapy, 1 as part of initial treatment and another for recurrence. Only 5 patients treated at TMH [5/9] achieved local control of their disease. Follow-up times ranged from 1 month to 134 months, median of 38 months. Distant metastases were identified in 4 patients [bone n = 1 and lung n = 3]. Median survival was 38 months. Overall survival at 5 years was 37% by Kaplan-Meier method, but this figure should be treated with caution since only 6 patients had a follow-up of more than 2 years. Tracheal cancer is a rare malignancy. Radiation therapy is a reasonably effective modality for unresectable disease