Urology Annals (Jan 2020)
The outcomes of renal cell carcinoma in a single tertiary care facility in Saudi Arabia
Abstract
Background: Amidst an era of rising malignancies worldwide, renal cell carcinoma (RCC) is the 7th most commonly detected, owing to 144,000 cancer-related deaths annually. Demographic knowledge of such cases in Saudi Arabia is poorly portrayed. According to the 2014 Saudi Cancer Registry, RCC has rated the 10th most common malignancy among males, posing a significant disease burden. Global studies have depicted a great discrepancy of 15 folds in the incidence of RCC among different countries, which is commonly attributed to variations in each countries development. We aimed to assess the overall survival (OS) and disease-free survival (DFS) in patients who underwent nephrectomy in our health-care facility. Materials and Methods: This is a retrospective study done at a tertiary care facility of all cases of RCC as per the pathology department database for the period of 2007–2017. The OS and DFS were statistically determined using Stata/SE 15.0. Results: Overall, 109 RCC patients were included in the study. Mean age at diagnosis was 53.8 (range: 24–89) years. Demographic data revealed a total of 71 (65.14%) males included in the study and 38 (34.86%) females. The OS at 2 years and 5 years was noted to be 95.3% and 92.6%, respectively. The DFS was found to be 90.8% at 2 years and 85.4% at 5 years. On multivariate analysis of the results, step-wise model was utilized to eliminate irrelevant variables affecting the OS, with a probability to eliminate variables with P > 0.2. Metastasis (M) was found to be a relevant variable (hazards ratio [HR]: 52.25 [P = 0.003]; 95% confidence interval [CI]: 3.75–728.88). On multivariate analysis of the DFS, variables were found to be significant which include gender (HR: 0.15 [P = 0.063]; 95% CI: 0.02–1.105), nationality (HR: 16.1 [P = 0.034]; 95% CI: 1.24–209.13), age at diagnosis (HR: 0.93 [P = 0.031]; 95% CI: 0.87–0.99), and pathological stage (T) (HR: 7.89 [P = 0.003]; 95% CI: 1.98–31.36). Conclusions: Our results revealed a notable discrepancy in the 5-year OS and the 5-year DFS as compared to studies in the literature. However, our study was limited to a single center and the majority of our patients were diagnosed at a rather early stage. With the rising number of RCC cases worldwide and in Saudi, this further necessitates extensive disease surveillance for trends in all parameters.
Keywords
