Renal cell carcinoma in dialysis patients: a single center experience.
OBJECTIVE
Renal cell carcinoma (RCC) is a life-threatening complication of end-stage renal disease with an unclear pathogenesis. We evaluated RCC developing in patients undergoing dialysis.


METHODS
In 2624 patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis at our hospital between July 1993 and March 2004, we performed annual screening for RCC using abdominal computed tomography and ultrasonography. Patients diagnosed with RCC underwent radical nephrectomy as well as clinical and pathologic evaluation.


RESULTS
RCC was detected in 44 patients (1.68%; 31 males and 13 females). The age of RCC patients was 55.5 +/- 11.1 years. Dialysis duration before RCC diagnosis was 11.2 +/- 7.2 years. Most RCC were early stage and low stage by TNM classification, 43 patients had N0M0 RCC, whereas one had N1M0. Tumor size was 2.9 +/- 1.9 cm. The predominant histological type of RCC was common or conventional cell-type carcinoma (clear cell carcinoma and granular cell carcinoma). Of patients, 5(11.4%) had bilateral RCC, and satellite tumor lesions in RCC were detected in 13 (29.5%). In 36 patients (81.8%) RCC was accompanied by acquired cystic disease of the kidney. These patients had longer dialysis durations (P = 0.01) and smaller tumors (P = 0.048). RCC metastasized postoperatively in 4 patients (9.1%), while one (2.3%) died of cancer.


CONCLUSIONS
Our dialysis patients showed a higher incidence of RCC than the general population. Prognosis was favorable because tumors were detected by screening when they were small. Therefore, periodical screening for RCC seems very important in dialysis patients.
Kojima
Yasuyuki
Y
Inoue Hospital, Urology, Osaka, Japan. yakojima@soryu.jp
Takahara
Shiro
S
Miyake
Osamu
O
Nonomura
Norio
N
Morimoto
Akira
A
Mori
Hiroshi
H
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006436:Hemodialysis Units, Hospital; D006801:Humans; D015994:Incidence; D052177:Kidney Diseases, Cystic / Q000150:complications / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D007680:Kidney Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009392:Nephrectomy; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D012189:Retrospective Studies