Local survival outcomes in metastatic renal cell carcinoma

Abstract

A quarter of patients who develop renal cell carcinoma will have metastatic disease at presentation. The role of cytoreductive surgery in these patients is a topic of debate. The aim of this study was to analyse survival outcomes of patients treated in Malta who did and did not receive a nephrectomy. Data was gathered retrospectively from the Malta Cancer Registry and Mortality Data at the Department of Health Information, records of multidisciplinary team meetings held within the urology department at Mater Dei Hospital, hospital imaging and patient records. Data gathered included: patient demographics, date of diagnosis, TNM staging, tumour histology, Fuhrman grade, time to treatment and modality of treatment. Exclusions included: • Localized disease relapsing after surgery • Non-renal cell histological subtypes • Presence of metastasis at diagnosis not certain • Concomitant primary tumours 77 patients diagnosed over 5 years between 04.03.2005 and 13.2.2009 were included. The age at presentation ranged from 30 to 88 years, with a median age of 67 years. 11 were incidental findings and 47 were symptomatic. The most prevalent symptoms were abdominal pain and gross haematuria. Five-year cancer specific survival in patients who received a nephrectomy was significantly better at 65%, compared to patients who did not undergo surgery (32%) P value <0.05, CI 95%. These results where compared favourably with SEER data outcomes