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

Renal cell carcinoma in children. Prognostic factors

To determine the outcome in childhood renal cell carcinoma and the role of surgical and radiation treatment. The records of 21 children with renal cell carcinoma were reviewed, 15 patients treated in the University of Toronto centers from 1959 through to 1997 and 6 patients treated in King Faisal Specialist Hospital, Riyadh, Kingdom of Saudi Arabia from 1975 through to 1998. The age was 3-17 [median 13] years. Systematic metastases were present at diagnosis in 5 patients. Regional nodal spread was present in 9 patients and 7 patients had localized disease alone. In the 16 M0 patients, the surgical treatment was radical nephrectomy [14 patients] partial nephrectomy [one patient] and wedge resection [one patient]. Postoperative radiation treatment was utilized in 8 [50%] of these patients. The 5 year survival rate for all patients was 52%, and for M0 patients was 70%. No patient with systematic metastases at diagnosis survived beyond 26 months. Four of 7 node negative patients and 8 of 9 node positive patients remained in first complete remission, with the duration of follow up 1-30 [Median 5] years. Seven of 8 M0 patients who did not receive adjuvant radiation therapy continued in first remission [3N0, 2NI, 2N2], compared with 5 of 8 patients who received postoperativeradiation treatment [1 N0, 2 NI, 2 N2]. The prognosis of localized renal cell carcinoma in childhood may be better than in the adult. Gross complete resection is required for long term survival. Elective postoperativeradiation treatment is not indicated