Renal cell carcinoma in dialysis patients: A single center experience

Abstract

Aim: Renal cell carcinoma (RCC) is a life-threatening complication of end-stage renal disease with an unclear pathogenesis. We evaluated RCC developing in patients undergoing dialysis. Methods: In 2624 patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis at our hospital between July 1993 and March 2004, we performed annual screening for RCC using abdominal computed tomography and ultrasonography. Patients diagnosed with RCC underwent radical nephrectomy as well as clinical and pathologic evaluation. Results: RCC was detected in 44 patients (1.68%; 31 males and 13 females). The age of RCC patients was 55.5 ± 11.1 years. Dialysis duration before RCC diagnosis was 11.2 ± 7.2 years. Most RCC were early stage and low stage by TNM classification, 43 patients had N0M0 RCC, whereas one had N1M0. Tumor size was 2.9 ± 1.9 cm. The predominant histological type of RCC was common or conventional cell-type carcinoma (clear cell carcinoma and granular cell carcinoma). Of patients, 5(11.4%) had bilateral RCC, and satellite tumor lesions in RCC were detected in 13 (29.5%). In 36 patients (81.8%) RCC was accompanied by acquired cystic disease of the kidney. These patients had longer dialysis durations (P = 0.01) and smaller tumors (P = 0.048). RCC metastasized postoperatively in 4 patients (9.1%), while one (2.3%) died of cancer. Conclusions: Our dialysis patients showed a higher incidence of RCC than the general population. Prognosis was favorable because tumors were detected by screening when they were small. Therefore, periodical screening for RCC seems very important in dialysis patients.Key words acquired cystic disease of the kidney, dialysis, end-stage renal disease, renal cell carcinoma.

Renal Cell Carcinoma in Dialysis Patients with End Stage Renal Disease: Focus on Surgery and Pathology

“…In United States, approximately 20% of those with ACDK will have RCC 5 . In Japan, Terasawa et al 4 , Satoh et al 29 and Kojima et al 11 reported 2.6% (41/ 1603), 0.61% (38/6201) and 1.68% (44/2624) of RCC in their patients on hemodialysis,respectively. Such an incidence of RCC appears significantly high, compared with that reported in the general Japanese population where RCC develops in 7.1 of 100000 men and 3.1 of 100000 women, and age-standardized incidence rates per 100 000 population for men and women were 4.9 and 1.8, respectively 30 .…”

Obesity, Diabetes Mellitus, Hypertension and other Risk Factors for Renal Cell Carcinoma in Japan: A Mini-Review

“…In East Asia, Cheung et al [34] reported that chronic dialysis patients showed a significantly higher incidence and mortality of kidney cancer than general population in Hong Kong while Chien et al [35] found that dialysis patients increased the risk of dying from kidney cancer compared to the general population in Taiwan. In Japan, Satoh et al [11] reported that 38 (0.6%) out of 6201 dialysis patients [12] reported that 44 patients (1.7%) were pathologically diagnosed with renal cell carcinoma in 2,624 dialysis patients between 1993 and 2004. These incidences of kidney cancer among dialysis patients appear higher than the incidence of general population (i.e., 7.1/100,000 for males and 3.1/100,000 [36]).…”

“…Satoh et al [11] conducted a retrospective cohort study of 6,201 chronic dialysis patients between 1990 and 2003, while Kojima et al [12] carried out a prospective cohort study of the 2,624 dialysis patients between 1993 and 2004 [12]. The final study is the summary of annual nation-wide questionnaire studies from 1982 to 2004 conducted by the Japanese Society for Dialysis Therapy [13].…”

“…These findings suggest that environmental factors (i.e., non-genetic risk factors) may play an important role in the development of kidney cancer. Therefore, we identified relevant studies [4][5][6][7][8][9][10][11][12][13] in the PubMed database using a combination of the search terms "Japan", "kidney cancer", "renal cell carcinoma" and "risk". In the ICHUSHI database (the Japanese database) we used a combination of the search terms "kidney cancer /renal cell carcinoma", and "risk factor" (the last search update on May 2017).…”

“…In this paper, we would like to introduce the result of these studies on the risk factors for kidney cancer in the Japanese population [4][5][6][7][8][9][10][11][12][13][14].…”