Publication:

A clinical study of patients with renal cell carcinoma

Background In 1894 Lubarch endorsed the idea of these being a suprarenal original tumour, and the term “hypernephroid tumors” indicating origin above the kidney was advocated by Birch-Hirschfeld. It was this semantic and conceptual mistake that led to the introduction of the term “hypernephroma”, which predominates in the literature describing parenchymal tumours of the primary renal origin. The objective was to study the surgical profile, treatment modalities for patients with renal cell carcinoma.

Methods Present study was retrospective as well as prospective study and was carried out in the Department of Surgery, Government Medical College and Hospital; Auragnabad for a period of one year Retrospective study was done from the record in Radiotherapy Department of this college. Prospective study was done with the number of cases of kidney tumors admitted during the study period. Total number of cases studied were 44, out of these, 26 was studied retrospectively and 18 cases prospectively. Patients who were absconded after admission are also included.

Results The youngest patient of renal cell carcinoma was found to be of 35 years, and oldest of 70 years old. The maximum incidence was found in 5th and 6th decade of life. In this treatise, maximum numbers of cases were presented with lump in abdomen (78.27%), and classic triad of pain, lump and hematuria was only in 4 cases (17.40%). Maximum numbers of patients were in stage III and IV. Anemia was found only in 6 cases (26.10%) and raised E.S.R. in 2 cases (08.70%). Not a single patient showed hypercalcemia or erythrocytosis. Most commony used treatment modality in our patients was Nephrectomy + RT + CT + HT in 9 cases (39.13%).

Conclusions Commonest etiological factor for renal cell carcinoma is smoking (30.50% of the cases). Maximum cases of renal cell carcinoma were presented with lump in abdomen and classic triad was found in only 17.4% of cases (i.e. pain, hematuria and lump). Maximum cases of renal cell carcinoma were found to be in stage III and IV. Majority of the renal cell carcinomas were treated with nephrectomy, postoperative radiotherapy, chemotherapy and hormonal therapy in combination.