Influence of Age on the Prognosis of Patients with Renal Cell Carcinoma (RCC)

Abstract

Objective: Aim of this study was to analyze the prognostic value of age in patients with renal cell carcinoma (RCC). Patients and Methods: A group of 15 patients (age ≤ 40 years, group I) and a group of 103 patients (age ≧ 50 years, group II) with sporadic RCC who underwent radical nephrectomy between 1985 and 1997 were compared. The two groups were analyzed with respect to histologic cell type, tumor grade, stage and outcome. Results: In group I low-stage tumors (stage I and II) were diagnosed in 93% of patients and in group II in 65% of the patients (p = 0.017). High-grade tumors (stage III and IV) were diagnosed in 7% and 35% of patients in group I and group II, respectively (p < 0.01). In group I only one patient (7%) with stage II disease died of cancer. In group II the distribution of cancer-specific mortality was as follows: 6 patients (100%) with stage IV, 13 patients (42%) with stage III, and 12 patients (17%) with stage I and II died of disease. The 5-year-survival in group I was 93% and in group II was 77% (p = 0.05). Conclusion: According to our data we conclude that RCC is diagnosed at a lower stage in young patients than in the older patient group. RCC may exhibit a more favorable prognosis in young patients, possible due to the lower stage at time of diagnosis.

Clinicopathological features and survival rates of patients with renal cell carcinoma under 50 years of age

“…One possible explanation for this condition might be younger patients are generally healthier and are rarely admited for tumor screening [5]. In accordance with the literature [1,3,[5][6][7]10,11], 67.9% of our patients were symptomatic and prevailing symptoms were pain and hematuria. Similarly, Sanchez-Ortiz et al reported 81% incidence of symptomatic tumors in their series [11].…”

“…In the present study, clear cell and papillary histologic types were detected in 67.9% and 14.3% of the patients, respectively. Although very few studies reported that younger patients had a higher incidence of papillary histology than adults, clear cell type was the dominant subtype among all [3,6]. In these studies, the incidence of papillary histology in younger and older patients were 13% versus 5% and 20.4% versus 11.4%, respectively [3,6].…”

“…Although very few studies reported that younger patients had a higher incidence of papillary histology than adults, clear cell type was the dominant subtype among all [3,6]. In these studies, the incidence of papillary histology in younger and older patients were 13% versus 5% and 20.4% versus 11.4%, respectively [3,6]. Abou El Fettouh et al [1] and Denzinger et al [2] also demonstrated a higher rate of papillary type (16% and 18.6%, respectively) in their series.…”

“…Despite no agreement on the exact age limit in order to consider patients with RCC as young adults. Several studies accepts 35-45 years as the upper limit [2,6,10] and 14-26 as the lower limit [1][2][3]7,11]. Additionally, some of the studies even included benign lesions of the kidney in their series [5,12] which we think affect interpretation of results.…”

“…Renal cell carcinoma (RCC) is the most common renal parenchymalmalignancy which accounts for 3-6% of all adult malignancies and represents 85% of all renal malignant tumors [1][2][3]. The peak incidence of these tumors generally occurs between 60 and 70 years of age [4].…”