title: Comparison of presentation and outcome for patients 18 to 40 and 60 to 70 years old with solid renal masses.
abstract: OBJECTIVE
  We compared histological subtype, pathological features and outcome of patients with solid renal masses who were 18 to 40 years old vs patients who were 60 to 70 years old.
  
  
  METHODS
  We conducted a retrospective review of the Mayo Clinic Nephrectomy Registry from 1970 to 2000, and identified 124 patients 18 to 40 years old and 1,067 patients 60 to 70 years old available for analysis.
  
  
  RESULTS
  There was no significant difference in the incidence of benign solid renal masses between patients 18 to 40 years old and those 60 to 70 years old (13.7% vs 10.2%). Among patients with renal cell carcinoma (RCC), younger patients were more likely to have chromophobe RCC (13.1% vs 3.6%) and less likely to have clear cell RCC (70.1% vs 81.5%) than older patients. Among patients with clear cell RCC, younger patients were more likely to have stage pT2b or lower tumors (82.7% vs 69.9%) and a higher incidence of cystic clear cell RCC (10.7% vs 2.2%) than older patients. Younger patients had an improved cancer specific survival compared with older patients but this difference was not statistically significant (risk ratio 0.71, p =0.127).
  
  
  CONCLUSIONS
  We found that patients 18 to 40 years old were more likely to have chromophobe and less likely to have clear cell RCC compared with patients 60 to 70 years old. We did not identify a higher incidence of papillary RCC in younger patients. Patients with clear cell RCC 18 to 40 years old had a higher incidence of low stage and cystic tumors compared with patients 60 to 70 years old, features which have been shown to have a favorable prognosis. These factors likely contributed to improved cancer specific survival for younger patients.
authors.affiliation: Division of Urology, Southern Illinois University, Springfield, Illinois, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Gillett
authors.forename: John C
authors.initials: JC
authors.lastname: Cheville
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Karnes
authors.forename: Christine M
authors.initials: CM
authors.lastname: Lohse
authors.forename: Eugene D
authors.initials: ED
authors.lastname: Kwon
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Leibovich
authors.forename: Horst
authors.initials: H
authors.lastname: Zincke
authors.forename: Michael L
authors.initials: ML
authors.lastname: Blute
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000238:Adenoma, Chromophobe / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000367:Age Factors; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D052177:Kidney Diseases, Cystic / Q000401:mortality / Q000473:pathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000401:mortality* / Q000473:pathology; D012737:Sex Factors; D016019:Survival Analysis