Renal cell carcinoma in New Zealand: a national survival study.
OBJECTIVE
To determine clinical and pathologic prognostic factors for renal cell carcinoma (RCC) using cases reported to a population-based cancer registry.


METHODS
All cases of RCC reported to the New Zealand Cancer Registry between 1976 and 1986 were retrieved and data analyzed to determine parameters of prognostic importance.


RESULTS
In eleven years, 1,308 cases of RCC (66.7% males and 33.3% females) were reported to the New Zealand Cancer Registry. The age-standardized incidence rate was 3.78 per 10(5) person-years and showed no significant trend over the period of the study. There was a significant difference in the age at presentation between the largest racial groups (Maori 52.2 years; non-Maori 63.2 years), which is accounted for by increased predisposing risk factors among Maori. The five-year actuarial survival rate was 42.4 percent with 63 percent of patients reported dead in follow-up to December 1990. In the series, patient gender (female > male), tumor laterality (right > left), stage (intrarenal > localized > disseminated), grade (1 > 2 > 3 > 4), and treatment modality (surgery > nonsurgery) were found to be significant prognostic factors, although only tumor stage and treatment modality were of independent significance. Tumor laterality was of prognostic significance for Stage II (localized) surgically treated tumors only.


CONCLUSIONS
The results of the study emphasize the paramount importance of tumor stage as a prognostic parameter for RCC. The prognostic significance of laterality for localized, surgically treated tumors suggests that radical nephrectomy is less likely to result in tumor clearance for left-sided RCC than for tumors on the right side.
Delahunt
B
B
Department of Pathology, Wellington School of Medicine, University of Otago, New Zealand.
Bethwaite
P
P
Nacey
J N
JN
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009520:New Zealand / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D012744:Sex Ratio; D015996:Survival Rate