Departments of Oncology and Urology, Soroka University Medical Center, Ben-Gurion University of the Negev, Faculty of Health Sciences, Beer Sheva, Israel.
*Correspondence to: Wilmosh Mermershtain E-mail: wilmosh@bgumail.bgu.ac.il
To Compare the clinical presentation and outcome between incidentally diagnosed and symptomatic renal cell carcinoma (RCC).
Between 1985 and 1998, 209 patients with renal cell carcinoma underwent radical nephrectomy. The mean age was 64 years. Male:female ratio was 1.5:1. 126 (60%) of patients were diagnosed incidentally (Group-I) and 83 (40%) of patients were symptomatic (Group II) at diagnosis.
In Group-I, (incidental carcinoma) 76% of patients (n=96) had Stage I-II, and 24% (30) had Stage III-IV disease. The incidentally diagnosed carcinoma were diagnosed by ultrasound performed for other reasons. In Group-II (symptomatic RCC-57% (47) of patients had Stage I-II, and 43% (36) had Stage III-IV disease. In this group, most common presenting symptoms were hematuria (48%), flank pain (42%), and flank or abdominal mass (9%). Only one patient (1.2%) presented with the classic triad of pain, flank mass and hematuria. Five-years survival was 84% in group-I (incidentally diagnosed) compared to 59% in group - II (symptomatic RCC).
Present study confirms the earlier observations that asymptomatic (incidentally diagnosed) patients have small primary tumour and early stage with higher overall survival compared to those with symptomatic RCC. Role of routine screening by ultrasound remains debatable in view of lower incidence of RCC in population.
