title: Tumour characteristics and surgical treatment of renal cell carcinoma in Sweden 2005-2010: a population-based study from the national Swedish kidney cancer register.
abstract: OBJECTIVE
  Tumour characteristics, preoperative work-up and surgical treatment in patients diagnosed with renal cell carcinoma (RCC) between 2005 and 2010, and changes over time were studied in a national population-based cohort.
  
  
  METHODS
  The National Swedish Kidney Cancer Register (NSKCR) contains information on histopathology, Fuhrman grade and clinical stage at presentation, and on the preoperative work-up and surgical treatment of patients with RCC. Between 2005 and 2010, 5553 RCC patients were registered in the NSKCR, 99% of those registered in the National Cancer Registry.
  
  
  RESULTS
  During the study period the mean tumour size decreased from 70 to 64 mm (p = 0.024) and the frequency of metastatic RCC decreased from 22% to 15% (p < 0.001). The use of preoperative chest computed tomography increased from 59% to 84%. In total, 4229 (76%) patients were treated with curative intent, 3453 (82%) underwent radical nephrectomy, 606 (14%) partial nephrectomy (PN) and 170 (4%) cryotherapy or radiofrequency ablation. In tumours up to 4 cm, PN was performed in 33% of the surgically treated patients. PN irrespective of size increased from 8% to 20% and laparoscopic nephrectomy increased from 6% to 17% during the period. In patients with metastatic RCC, 55% underwent cytoreductive nephrectomy.
  
  
  CONCLUSIONS
  The NSKCR explores population-based data on the clinical handling of patients with RCC. This study, between 2005 and 2010, shows significant decrease in tumour size and metastatic RCC at presentation, a more complete preoperative work-up, and significantly increased use of PN and laparoscopic nephrectomy in Sweden.
authors.affiliation: Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute , Stockholm , Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Thorstenson
authors.forename: Martin
authors.initials: M
authors.lastname: Bergman
authors.forename: Ann-Helén
authors.initials: AH
authors.lastname: Scherman-Plogell
authors.forename: Soheila
authors.initials: S
authors.lastname: Hosseinnia
authors.forename: Börje
authors.initials: B
authors.lastname: Ljungberg
authors.forename: Jan
authors.initials: J
authors.lastname: Adolfsson
authors.forename: Sven
authors.initials: S
authors.lastname: Lundstam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy; D012042:Registries; D012189:Retrospective Studies; D013548:Sweden; D047368:Tumor Burden; D055815:Young Adult
keywords: distant metastasis; lymph-node metastasis; population-based; renal cell carcinoma; survival; tumour category; tumour size