Clinical prognostic factors and survival outcome in renal cell carcinoma patients--a malaysian single centre perspective.
BACKGROUND
This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms.


METHODS
The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis.


RESULTS
The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, 9.5±4.3cm, was larger than non palpable masses, 5.3±2.7cm (p<0.001).


CONCLUSIONS
This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.
Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia E-mail : rretnagowri@gmail.com.
Ning Yi
NY
Yap
Keng Lim
KL
Ng
Teng Aik
TA
Ong
Jayalakshmi
J
Pailoor
Glenda Carolyn
GC
Gobe
Chong Chien
CC
Ooi
Azad Hassan
AH
Razack
Norman
N
Dublin
Christudas
C
Morais
Retnagowri
R
Rajandram
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000401:mortality; D005500:Follow-Up Studies; D006417:Hematuria / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010146:Pain / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D015431:Weight Loss