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

ABSTRACT

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