Management of Kidney Cancers in Urology Department of the Gabriel Toure University Hospital/Bamako

Abstract

Objective: to report our experience in the management of adult kidney cancer. Patients and Methods: This was a prospective and descriptive study, carried out in the for a period of six years, interesting all the medical records of 24 adult patients diagnosed with kidney cancer. Results: During the study period, 24 patients met our inclusion criteria; the mean age was 48.23 ± 8.02 years with extreme ranging from 17 to 82 years. Most of our patients were female (58.3%), and were referred or consulted for lumbar mass in 66.7% of cases. The average tumor size was 13.6 ± 5.8 cm with extremes of 7.8 to 21.1 cm. Management included total nephrectomy in 50% and total nephrectomy expanded in 50% of cases. The histological type found was renal cell carcinoma in 23 patients and papillary carcinoma in one patient. Conclusion: Kidney cancer is rare in our context, its clinical and histological characteristics remain the same for two decades. Its management is largely based on enlarged total nephrectomy.

Adult Kidney Cancer in the Thies Region: Epidemiological, Diagnostic and Therapeutic Aspects

“…In our study, the discovery of kidney cancer was made at a symptomatic stage in relation either to a locally advanced tumor or to the presence of metastases. This trend has been reported in other African series [6,8,[13][14][15][16]]. In the literature, the classic triad associating hematuria, flank pain and lumbar mass is present in less than 10% of cases [17,18].…”

“…The most common histological type of kidney cancer in our series is clear cell renal cell carcinoma (% of cases). There is no significant difference compared to other series in the literature [4,[13][14][15][16].…”

Management of Renal Cell Carcinoma—Current Practice in Sub-Saharan Africa

“…Pooled results from the reviewed data showed a mean duration of symptoms from onset to presentation at 17.6 months with a range of 1–192 months. Most published literature in West Africa reported flank pain, hematuria, and lumbar mass as the commonest clinical presentation with lumbar mass being highlighted in all the studies reviewed (10–17, 19, 20). Smoking (10, 20), hypertension (10, 16, 20), obesity (20), family history (14), and exposure to industrial dyes (14) were the risk factors associated with renal malignancy reported from the sub-Saharan literature (Table 2).…”

“…Histological reports from sub-Saharan nations revealed that RCC was the commonest histological type of cancer with clear cell carcinoma being the most dominant variant at an average of 61.6% (Table 3). The average tumor size from four publications (10, 11, 14, 17) was 15.1 cm with a range of 2.4–30 cm. An average of 74.4% of patients presenting with renal masses were managed with radical nephrectomy.…”

“…Data from the review showed heterogenous results on the perioperative mortality following radical nephrectomy in the sub-Saharan region. However, analysis of reports from Nigeria (14, 19), Togo (16), and Mali (17) showed a perioperative mortality of 5.1% following radical nephrectomy. Most of these deaths were due to perioperative hemorrhage or pulmonary complications.…”