Global incidence and mortality of renal cell carcinoma in 2020 / 中华流行病学杂志

Objective: To analyze the global epidemiology of renal cell carcinoma (RCC) in 2020. Methods: The incidence and mortality data of RCC in the cooperative database GLOBOCAN 2020 of International Agency for Research on Cancer of WHO and the human development index (HDI) published by the United Nations Development Programme in 2020 were collated. The crude incidence rate (CIR), age-standardized incidence rate (ASIR), crude mortality rate (CMR), age-standardized mortality rate (ASMR) and mortality/incidence ratio (M/I) of RCC were calculated. Kruskale-Wallis test was used to analyze the differences in ASIR or ASMR among HDI countries. Results: In 2020, the global ASIR of RCC was 4.6/100 000, of which 6.1/100 000 for males and 3.2/100 000 for females and ASIR was higher in very high and high HDI countries than that in medium and low HDI countries. With the rapid increase of age after the age of 20, the growth rate of ASIR in males was faster than that in females, and slowed down at the age of 70 to 75. The truncation incidence rate of 35-64 years old was 7.5/100 000 and the cumulative incidence risk of 0-74 years old was 0.52%. The global ASMR of RCC was 1.8/100 000, 2.5/100 000 for males and 1.2/100 000 for females. The ASMR of males in very high and high HDI countries (2.4/100 000-3.7/100 000) was about twice that of males (1.1/100 000-1.4/100 000) in medium and low HDI countries, while the ASMR of female (0.6/100 000-1.5/100 000) did not show significant difference. ASMR continued to increase rapidly with age after the age of 40, and the growth rate of males was faster than that of females. The truncation mortality rate of 35-64 years old was 2.1/100 000, and the cumulative mortality risk of 0-74 years old was 0.20%. M/I decreases with the increase of HDI, with M/I as 0.58 in China, which was higher than the global average of 0.39 and the United States' 0.17. Conclusion: The ASIR and ASMR of RCC presented significant regional and gender disparities globally, and the heaviest burden was in very high HDI countries.

Masas renales pequeñas: predictores de malignidad en una serie de 10 años / Small renal masses: analysis of 152 cases

Background: Small renal masses (SRM) are defined as complex organ-confined solid or cystic lesions < 4 cm. Up to 20% of these can be benign. A conservative management with active surveillance can be done in some patients. However, it is difficult to identify patients with a higher risk of malignancy. Aim: To characterize the clinical, radiological and histopathological aspects of patients with SRM, analyzing predictive factors for tumor aggressiveness. Material and Methods: Retrospective analysis of a cohort of patients undergoing partial or total nephrectomy for renal tumors between 2006 and 2016. All tumors of 4 cm or less were included. Four histological groups were defined: benign, favorable, intermediate and unfavorable. Two categories of risk were also defined: low and high. Preoperative clinical and radiological variables of these patients were analyzed. Results: Data of 152 patients were analyzed. Six percent had a benign histology, and the majority was of intermediate risk (74%). According to histological type, clear cell carcinoma was the most common type (74%). Three percent were benign angiomyolipomas. No malignancy predictive variable was identified. Conclusions: In these patients, the percentage of benign SRM was low. No variable that could predict the presence of a benign or malignant lesion in the definitive biopsy was identified.

Male Genitourinary Tumors : 14 Years Experience in Garhwal Region of India.

Genitourinary tumors may show varied clinical presentation and frequency in different regions of the world. The present study was therefore conducted to analyze the frequency, clinical presentation and the histopathological types of the various male genitourinary tumors diagnosed over a period of 14 years in a major teaching institute of north Himalayan region of India. Material and Methods: Retrospective study was undertaken in the Pathology department of the Institute which included all the cases of male genitourinary tumors which were diagnosed on histopathology from the time period between 1 Jan 1997 till 31st Dec. 2010. Results: The study showed that prostate was the most common site for male genitourinary tumors with prostatic adenocarcinoma as the most common histopathological type of tumor. Testicular Non- Hodgkin’s lymphoma constituted about 8% of total tumors in testes which mostly presented in elderly age group. Renal cell carcinoma (66.2%) was the most common tumor in kidney with much lower frequency of Wilm’s tumor (16.9%). Occasional rare tumors such as hemangioma of urinary bladder and schwannoma of penis were also seen over 14 years. Conclusion: The study concludes clinically patients were associated with more severe symptoms as they presented late to the hospital from the remote areas of this Himalayan region leading to late detection of tumors. Prostatic adenocarcinoma was the most common tumor while renal cell carcinoma was most common tumor in kidney. The present study provides valuable information to clinicians and pathologists regarding frequency, clinical presentation and histopathological types of male genitourinary tumors in this region which can be further used to formulate strategies for better management of these tumors.

Novel three missense mutations observed in Von Hippel-Lindau gene in a patient reported with renal cell carcinoma.

Von Hippel‑Lindau (VHL) disease is an autosomal dominant hereditary cancer syndrome that predisposes to the development of a variety of benign and malignant tumors, especially cerebellar hemangioblastomas, retinal angiomas and clear‑cell renal cell carcinomas (RCC). We have identified of VHL gene using immunohistochemistry in a patient who was diagnosed for RCC. In order to understand the involvement of mutation in the VHL gene exon 1 was amplified and sequenced (accession number: JX 401534). The sequence analysis revealed the presence of novel missense mutations c.194 C>T, c.239 G>A, c.278 G>A, c.319 C>G, c. 337 C > G leading to the following variations p.Ala 65 Val, p.Gly 80 Asp, p.Gly 93 Glu, p.Gln 107 Glu, p.Gln 113 Glu in the protein.

Clinical characteristics and outcomes in renal transplant recipients with renal cell carcinoma in the native kidney

BACKGROUND/AIMS: We investigated the incidence and clinical characteristics of renal cell carcinoma (RCC) in the native kidney of renal transplant recipients. METHODS: Between 1991 and 2010, 1,425 patients underwent kidney transplantation at our institution. We retrospectively evaluated the clinical features and outcomes in renal transplant patients with RCC in the native kidney after renal transplantation. RESULTS: The patients included three males and two females with a mean age of 63 years (range, 52 to 74). The incidence of RCC was 0.35%. The median interval between renal transplantation and RCC occurrence was 16.2 years (range, 9 to 20). All of our patients with RCC had developed renal cysts either before (n = 3) or after (n = 2) renal transplantation. The mean duration of dialysis was 12 months (range, 2 to 39). Of the five patients, four underwent dialysis treatment for less than 8 months. All the RCCs were low grade at the time of diagnosis. Four patients underwent radical nephrectomy, and one patient refused the operation. The four patients who underwent radical nephrectomy showed no evidence of local recurrence or distant metastasis during the median follow-up of 2.9 years. However, the patient who did not undergo surgery developed spinal metastasis from the RCC 6 years later. CONCLUSIONS: This study suggests that the follow-up period is an important factor for the development of RCC in renal transplant recipients, and more vigorous screening with a longer follow-up period is required in renal transplant recipients.

Mucinous tubular and spindle cell carcinoma of kidney: A clinicopathologic study of six cases.

Background: Mucinous tubular and spindle carcinoma (MTSCC) of kidney is a rare, low-grade polymorphic tumor. Recent studies have described a wide morphology spectrum of this tumor. Aim: To report the clinico-pathologic features of six cases of MTSCC of kidney. Materials and Methods: Six cases of MTSCC of kidney were studied and literature was reviewed. Immunohistochemistry was done by Envision method. Results: The age of the patients ranged from 44 to 84 years (mean 58.5 years). Four patients were males and two were females. The tumor was located in the left kidney in four cases and in the right kidney in two cases. The tumor size ranged from 4.5 to 15 cm (mean 6.4 cm). All tumors exhibited an admixture of tubules, spindle cells, and mucinous stroma in variable proportions. Tubules were predominant in five cases and spindle cells in one case. Psammomatous calcifications, papillations, and necrosis were seen in two cases. Collections of foamy histiocytes were noted in four cases. Cytoplasmic vacuoles and osseous metaplasia were seen in one case each. All cases were Fuhrman's nuclear grade II. Five cases were of stage pT1, and one was pT3. All cases stained positive for alcian blue at pH 2.5. Immunohistochemical stain CK7 was positive in all cases and CD10 was positive in 1/1 case. All patients were alive and well at follow-up of 12-59 months (mean 33.5 months). No metastases were detected. Conclusions: We report six cases of MTSCC of kidney, a rare distinct variant of RCC, with a favorable prognosis. A male predominance was seen in our cases. MTSCC shares histologic and immunohistochemical overlap with papillary renal cell carcinoma (PRCC) and cytogenetic analysis should be performed in difficult cases to avoid a misdiagnosis.

Renal cell carcinoma and systemic onset juvenile idiopathic arthritis.

Renal cell carcinoma (RCC) accounts for majority of malignancies arising out of the kidney. Paraneoplastic rheumatologic manifestations; myositis, vasculitis, and arthritis have been described in a few cases with RCC. Systemic onset juvenile idiopathic arthritis (JIA) is characterized by intermittent fever, arthritis, reticulo-endothelial cell hyperplasia and absence of rheumatoid factor and antinuclear antibodies. Herein, we report a 16-year-old boy with systemic onset JIA for 5 years who developed RCC and his systemic and articular symptoms paralleled the course of RCC. The common pathophysiologic influence of the cytokine Interleukin-6 possibly played a role in the exacerbation of symptoms of systemic onset JIA during the relapse of the RCC. The case is presented to highlight the rare co-occurrence of these two diseases and their influence on each other.

Epidemiologic characteristics of renal cell carcinoma in Brazil

PURPOSE: In Brazil, National data regarding the epidemiology of renal cell carcinoma (RCC) are scarce. The aim of this study was to describe the demographic, clinical, and pathologic characteristics of RCC diagnosed and treated by members of the SBU - Brazilian Society of Urology. MATERIALS AND METHODS: For this cross-sectional study, data were collected through an on line questionnaire available to the members of the Brazilian Society of Urology (SBU). Between May 2007 and May 2008, voluntary participant urologists collected data on demographic, clinical and pathological characteristics from patients diagnosed with RCC in their practice. RESULTS: Fifty SBU affiliated institutions contributed with patient information to the study. Of the 508 patients, 58.9 percent were male, 78.9 percent were white, and the mean age was 59.8 years. Smoking history, high blood pressure and a body mass index above 30 kg/m2 were present in 14.8 percent, 46.1 percent and 17.9 percent of the patients, respectively. Abdominal ultrasound and computed tomography were the main diagnostic methods. The majority of the cases were localized tumors and metastasis were presented in 9.5 percent of the patients; 98.4 percent underwent nephrectomy. Clear cell carcinoma was the most common histological type. In comparison with private institutions, stage IV disease was less frequent among patients treated at public health services (P = 0.033). CONCLUSIONS: RCC in Brazil is more common in white men in their sixth decade of life. Ultrasound is the main diagnostic tool for the diagnosis of clear cell carcinoma and we found that localized disease was predominant. A national registry of RCC is feasible and may provide valuable information.

Renal cell carcinoma: Clinico-pathological retrospective study on Yemeni patients

The aim of this study is to highlight the pattern of renal cell carcinoma among Yemeni patients and to correlate this type of cancer with some epidemiological risk factors. The clinical records of 22 patients with renal cell carcinoma, admitted to Al-Gamhoria Teaching Hospital in Aden and Ibn-Khaldoon General Hospital in Lahj Governorate between 1999 - 2002, were studied retrospectively. The mean age of the male patients was 55 years, and the females was 45 years. Renal cell carcinoma was more common in males than females, with a ratio of 2:1. Smoking habits was found in association with the disease in 73.3% of the male patients. Patients with blood group A were with higher rate [54.6%] of RCC than patients with other blood groups. Renal cell carcinoma affected the left kidney more than the right kidney. One third of the patients presented classical triad [hematuria, pain, mass]. Anemia and increased ESR were found in 77% and 91% of the cases respectively. Renal failure was present in 9% of the cases. Clear cell type was the most common pathological variant of RCC with 77%. We concluded that further studies of RCC in larger series are needed to elucidate the frequency, types, risk factors, and the relationship between blood group and renal cell cancers

Cáncer renal multicéntrico: presentación de serie clínica anatomopatológica y revisión de la literatura / Multicentric renal cancer: clinical series presentation and literature review

Introducción: El carcinoma renal muticéntrico es decir aquellos carcinomas que cuentan con un tumor principal y uno o más secundarios, ocurre en el 10 por ciento de los casos. Su ocurrencia se asocian entre otro, a factores tales como el tamaño tumoral y el tipo histológico. El riesgo de multicentricidad permite evaluar la mejor opción de tratamiento quirúrgico oncológico. Objetivos: Evaluar la frecuencia de multicentricidad en el carcinoma renal y factores morfológicos asociados. Material y método: Análisis de 165 nefrectomías radicales por tumor renal desde 1990 hasta el año 2005 por un protocolo preestablecido. Resultados: La multicentricidad se presentó en 18 casos (10,9 por ciento). El número promedio de tumores secundarios fue de 4,9 por caso, la concordancia con el grado nuclear de Furhman y el tipo histológico con el tumor principal fue de 100 por ciento y 66 por ciento respectivamente. 8 de los 18 casos (44 por ciento) correspondían a un estadio T1a de la OMS, de estos 5 eran carcinomas papilares. Del total de la muestra 6 de 6 (100 por ciento ) carcinomas papilares fueron multicéntricos y 12 de 148 (8,1por ciento) carcinomas de células claras fueron multicéntricos. Trece de 18 tumores principales median menos de 7 cm y el 93 por ciento de los tumores secundarios median menos de 2,5 cm. Conclusiones: La frecuencia de multicentricidad en el carcinoma renal fue cercana al 10 por ciento, casi la mitad de los casos se presentaron en el estadio T1a, de los cuales la mayoría correspondieron a Carcinomas papilares. El conocimiento del tipo histológico es importante a la hora de seleccionar el tipo de cirugía a practicar, en este caso por sobre el tamaño tumoral.

Introduction: Multicentric renal carcinoma (ie those that have a primary tumor and one or more secondary), occurs in 10 percent of cases. Its occurrence is associated to tumor size and histologic type. The multicentricity risk allows to assess the best surgical treatment. Objectives: To evaluate the frequency of multicentricity in renal cell carcinoma and his morphological factors.Material and methods: An analysis of 165 radical nephrectomies for renal tumors from 1990 until 2005 was conducted. Results: Multicentricity was found in 17 cases (10.9 percent). The average number of secondary tumors was 4.9; the correlation with histologic type and Furhman nuclear grade with the main tumor was 100 percent and 66 percent respectively. Eight cases (44 percent ) were stage T1a (5 were papillary carcinomas). 6 / 15 (40 percent) of papillary carcinomas were multicentric and 12/179 (6.7 percent) of clear cell carcinoma were multicentric tumors.13/18 of the primary tumor measured less than 7 cm and 93 percentof secondary tumors measured less than 2.5 cm. Conclusions: The frequency of multicentricity in renal cell carcinoma was 10 percent, most of the cases were in stage T1a, most of which were papillary carcinomas. Knowledge of the histologic type is more important than the tumor size for the selection of the best surgical approach.

Adenocarcinoma renal: análisis y pronóstico de una muestra de 86 pacientes estudiados entre 1990 y 1999 en el Hospital Clínico de la Universidad de Chile / Renal cell carcinoma: analysis and prognosis of a sample of 86 patients from 1990 to 1999 at the Hospital Clínico de la Universidad de Chile

El Adenocarcinoma de células renales constituye el 3 por ciento del total de los tumores malignos, aproximadamente el 90 por ciento de los tumores primarios de origen renal y tercero en prevalencia en el área urológica luego de los de próstata y vesical. El objetivo de este estudio es caracterizar y analizar una muestra de 85 pacientes portadores de Adenocarcinoma renal de nuestro servicio y fundamentalmente evaluar su pronóstico según etapificación. Estudio descriptivo, retrospectivo de 85 pacientes (33,6 por ciento), de un total de 253 sometidos a nefrectomía radical renal unilateral entre 1990 y 1999, en el Hospital Clínico de la Universidad de Chile. Se analizan datos clínicos, diagnóstico radiológico, anátomo patológico, etapificación y pronóstico según clasificación TNM. Análisis estadístico mediante base de datos Epi Info 6.0. El promedio de edad fue de 61,9±3,6 años. Los pacientes hombres tuvieron un promedio de edad significativamente mayor (p<0,001) que las pacientes de sexo femenino (64,4±3,0 v/s 58,0±4,4). La distribución según género estadísticamente significativa (p<0,0001), hombres: 74 por ciento (62/85), mujeres: 26 por ciento (23/85). De la presentación destaca un 44 por ciento (37/85) como hallazgo asintomático y sólo un 35,2 por ciento (30/85) como triada clásica de hematuria, dolor y masa abdominal. No hubo diferencias significativas respecto de la lateralidad del tumor (49 por ciento izquierdos, 51 por ciento derechos). Etapificación: T1N0M0: 21,17 por ciento (18/85), T2N0M0: 29,41 por ciento (25/85), T1N1M0: 0 por ciento, T2N1M0: 0 por ciento, T3aN0-1M0: 23,53 por ciento (20/85), T3bN0-1M0: 21,76 por ciento (18/85), T4N0-1-2-3M0-1: 4,7 por ciento (4/85). Sobrevida actuarial a 5 años: T1N0M0: 100 por ciento (18/18), T2N0M0: 88 por ciento (22/25), T1N1M0; 0 por ciento, T2N1M0: 0 por ciento, T3aN0-1M0: 70 por ciento (14/20), T3bN0-1M0: 44,44 por ciento (8/18), T4N0-1-2-3M0-1: 0 por ciento (0/4). El Adenocarcinoma renal afecta principalmente durante la séptima década de la vida y es tres veces más frecuente en hombres que en mujeres. La presentación clínica más común es la asintomática, cobrando relevancia la utilización de métodos radiológicos para su diagnóstico. La incidencia encontrada tanto según estadio patológico como pronóstico no difiere de lo analizado en la literatura nacional e internacional

Incidence estimation of genitourinary cancer in Korea

A nation-wide study was performed to estimate the incidence of bladder, kidney, renal pelvis and ureter, prostate, testicular and other genitourinary cancer among Koreans in Korea using medical records of the inpatients of the beneficiaries of the Korea Medical Insurance Corporation (KMIC) from Jan. 1, 1989 to Dec. 31, 1989. The crude incidence rate of bladder cancer (ICD-9 188) is estimated to be 4.43 and 0.98 per 100,000 in males and females, respectively. Around 1,093 new cases of bladder cancer (895 male and 198 female) are estimated to occur in a year. The adjusted rate for the world population is 7.76 in males and 1.19 in females which is similar to that of Japanese in Osaka and Chinese in Shanghai, but lower than in American whites and blacks. The crude incidence of kidney, renal pelvis and ureteral cancer (ICD-9 189) is estimated to be 1.61 and 0.87 in males and females, respectively. Around 507 new cases of kidney, renal pelvis and ureteral cancer (332 male and 175 female) are estimated to occur in a year. The adjusted rate for the world population is 2.69 in males and 1.04 in females. In the prostate (ICD-9 185), the crude incidence rate of cancer is estimated to be 1.36. Around 274 new cases of prostate cancer are occurring in a year. The adjusted rate for the world population is 2.98 which is similar to the Chinese rate. The incidence of genitourinary cancer continuously increases with age.

Tumores renales: revisión de 13 años (1974-1987) / Renal tumors: a review of 13 years (1974-1987)

Se revisa un material constituido por 41 pacientes portadores de tumores renales sólidos atendidos en el Servicio de Urologia del Hospital San Juan de Dios entre julio de 1974 y junio de 1987. La edad promedio de la casuística fue de 56 años, siendo la década de 51 a 60 años la de mayor incidencia (31,7%). La distribución por sexo revela um muy leve predominio de hombres. La hematuria fue la causa más frecuente de consulta y de sospecha diagnóstica (46,3%), seguida de masa palpable y de dolor. La tríada hematuria, dolor y masa palpable sólo se presentó en el 14,6% de los casos. El carcinoma de células renales fue el tumor más frecuente (86,5%). Casi la mitad de los casos se encontraban en etapa D de Robson (43,8%) lo que demuestra la tardanza del diagnóstico. La intervención más practicada fue la nefrectomía (78,4%) realizada por vía abdominal anterior

Adenocarcinoma renal avanzado: conducta terapéutica / Renal adenocarcinoma: therapeutic behavior

Presentamos la experiencia de 10 años de nuestro servicio habiendo manejado 54 tumores renales de los cuales 42 son adenocarcinomas renales (78%). En 15 de nuestros pacientes el diagnóstico se hizo cuando la enfermedad se encontraba en etapa IV de diseminación (36%) lo que representa una cifra elevada. Mostramos las características de estos pacientes siendo 8 hombres y 7 mujeres lo que sale de la distribución habitual por sexo. La evolución de estos 15 casos confirma que la gram mayoría fallece antes de los 12 meses siendo raros los casos que superan los 5 años. Como aporte de esta serie mostramos las cifras de incidencia de este tumor en una población chilena

Estudo retrospectivo de 37 pacientes com tumor renal / Retrospective study form 37 patients with renal tumor

Foram observados 37 pacientes com carcinoma unilateral de células renais tratados entre 1973 e 1979 no Hospital de Clínicas de Porto Alegre. Para efeito de estagiamento, foi usado o sistema proposto por Flocks e Kadeski, sendo encontrados 83% dos pacientes em estágios 2 e 3. A incidência foi superior no sexo masculino, com uma média de 4 para 1, e a faixa etária mais comprometida foi a partir dos 50 anos. Apenas 3 pacientes apresentaram a chamada "tríade clássica", sendo a hematúria o sintoma isolado mais freqüente. Trinta pacientes foram submetidos à nefrectomia radical, sendo 17 empregada a incisäo transversa transperitoneal em "chevron" e em 13 a incisäo tóraco-abdominal. Estäo vivos e em controle 18 pacientes, com uma sobrevida de 5 anos (8,1%)