Renal cell carcinoma in patients with end-stage renal disease: a clinicopathological analysis
10.3760/cma.j.issn.0529-5807.2019.11.003
- VernacularTitle: 终末期肾病合并肾细胞癌的临床病理学特征
- Author:
Bing HE
1
;
Wei ZHANG
2
;
Lina LIU
3
;
Han WANG
1
;
Yuwei ZOU
1
;
Yanxia JIANG
1
;
Wenjuan YU
1
;
Hailei SHI
1
;
Yan LIU
2
;
Yujun LI
1
Author Information
1. Department of Pathology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
2. Department of Pathology, 971 Hospital of PLA Navy, Qingdao 266071, China
3. Department of Nuclear Medicine, 971 Hospital of PLA Navy, Qingdao 266071, China
- Publication Type:Journal Article
- Keywords:
Nephrosis;
Kidney neoplasms;
Carcinoma, renal cell;
Immunohistochemistry;
Prognosis
- From:
Chinese Journal of Pathology
2019;48(11):846-850
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinicopathological characteristics and prognosis of renal cell carcinoma (RCC) in patients with end-stage renal disease (ESRD).
Methods:The clinicopathological data of patients of renal cell carcinoma arising in end-stage renal disease were collected from the Affiliated Hospital of Qingdao University (ten cases) and 971 Hospital of PLA Navy (five cases) from January 2009 to August 2018.
Results:Among 15 patients, 14 were male and 1 was female, and the age ranged from 38 to 78 years (mean 51 years, median 49 years). All patients had history of chronic renal failure (7-192 months), including 9 patients treated with hemodialysis for 6 to 132 months. In 12 cases the tumor border was distinct and the tumor size ranged from 1.8 to 11.0 cm. Two cases were multifocal and one case showed extensive renal hemorrhage with an inconspicuous tumor mass. Microscopically, 9 cases were clear cell reanl cell carcinoma including one with sarcomatoid differentiation, 4 were acquired cystic kidney disease-associated(ACKD-RCC) and two were papillary renal cell carcinoma. All patients had a follow-up of 3 to 120 months. Four patients died during a follow-up of 6 to 60 months (mean 30 months) as a result of extensive distant metastases (two cases) and renal failure (two cases), while other eleven patients were alive without tumor recurrence or metastasis (median 40.8 months of follow-up ranging from 3 to 120 months).
Conclusions:ESRD-RCC is more often seen in younger male patients. The time intervals from the onset of chronic renal failure to the diagnosis of renal cell carcinoma differ and tumors are frequently incidental findings. The histological types can be sporadic renal cell carcinoma or unique ACKD-RCC. Tumors are often hemorrhagic and necrotic. Routine physical examination and early detection could benefit ESRD-RCC patients. ESRD-RCC may have a favorable prognosis despite of a large tumor size or the presence of sarcomatoid differentiation.
