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Estudio clínico-patológico de los adenocarcinomas renales incidentales

2005; SciELO; Volume: 58; Issue: 7 Linguagem: Inglês

10.4321/s0004-06142005000700007

1576-8260

E. Fernández Rosado, G. Suárez Pascual, A. Blanco Díez, Alfonso Barbagelata López, J.L. Ponce Díaz-Reixa, Serafín Novás Castro, M. Ruibal Moldes, Francisco Gómez Veiga, Venancio Chantada Abal, M. González Martín,

Cancer Genomics and Diagnostics

OBJECTIVES: To determine the percentageof renal cell carcinomas incidentally diagnosed (IRCC)and to compare their clinical and pathologicalcharacteristics with symptomatic or non-incidentallydiagnosed tumors (SRCC)METHODS: We retrospectively study 189 patients whowere diagnosed of renal carcinoma between 1990and 1999. 166 underwent surgery (149 radicalnephrectomy; 17 nephron-sparing surgery). Wedetermine the percentage of IRCC detected byradiological tests and compare them with the SRCCdiagnosed after presenting with some of the classicsymptoms or metastasis, with special focus on tumorsize, pathology stage, tumor recurrence, progressionand evolution. RESULTS: 87 SRCC (46%); 102 SRCC (54%). Thereare not differences in terms of age, gender, side, andpostoperative hospital stay. Tumor size was higher inthe SRCC (mean 8. 5 cm) than in the IRCC (6.3 cm).SRCC tumor stage was: pT1 27.3%, pT2 27.3%, pT3a23.8%, pT3b 16.6%, pT3c 2.3%, and pT4 2.3% ;IRCC stage was: pT1 51.3%, pT2 25.6%, pT3a10.9%, pT3b 10.9%, pT3c 1.2%, and no pT4. Thepercentage of patients with lymph node involvementwas higher (p = 0.02) in the SRCC (15%) than in theIRCC (4.8%). The percentage of patients with metastasisat the time of diagnosis was higher in the SRCC group(26%) than in the IRCC (9.2%). Recurrences were morefrequent in the SRCC Group (8.3%) than in the IRCC(1.2%) (p = 0.07). Tumor progression was morefrequent in the SRCC group (34%) than in the IRCC(7.3%) (p<0.01). 76% of the patients undergoingnephron sparing surgery were IRCC.CONCLUSIONS: Currently, there is a high percentageof IRCC (46% in our series from 1990-99). Renaltumors presenting as IRCC have better prognosis, sincethey have significantly smaller size, lower stage, lessadvanced disease, less recurrences, and less progressionthan SRCC.