Resumen
Background: To review all the cases of the patients with renal cell carcinoma seen during the study period and to determine the pattern of presentation, number of operable cases, histological types and outcome of treatment.
Materials and Methods: The data of the patients with renal cell carcinoma was retrieved from the Urology division audit book, theatre record books and case files from the health records department and pathology register in the department of pathology. The parameters studied were age, gender, pattern of presentation, number of patients who had surgery, histology types and the outcome of treatment.
Results: In total, there were 69 patients with renal cell carcinoma that accounted for 59.5% of all renal masses seen. The male to female ratio was 1:1. Their age ranged from 16 to 88 with a mean of 48 years and median of 50 years. The main clinical feature was loin swelling (100%) and others were loin pain (29%), hematuria (18.8%), weight loss (4%) and paraneoplastic syndrome (anaemia without haematuria) was seen in 2.9%. Ten percent of the cases had the classical triad of hematuria, loin pain and loin swelling. All cases were unilateral disease and 15 (21.7%) had metastasis at presentation. The pre-operative tests were abdominal ultrasound (94%), intravenous urography (45%) and CT-Scan (11.6%). Twenty eight patients (40.6%) had surgery of which 5 were unresectable. 37 of the patients (53.6%) were subsequently lost to follow-up. The 28 operative specimens were histologically confirmed and 85.7% were clear cell carcinoma. The 23 patients whose tumours
were resected have remained symptom free, some up to 5 years. However the five patients with unresectable tumours died between 3 to 6 months of exploratory surgery.
Conclusion: The patients with resectable tumour could remain disease free for a significant period afterwards despite late presentation. However, there is a high loss to follow-up rate.
Keywords: Renal cell carcinoma, resectable, late presentation, histology
Résumé
Contexte: Passer en revue tous les cas des patients avec insuffisance rénale carcinome baso-cellulaire vu au cours de la période à l’étude de déterminer le modèle de présentation, le nombre de cas exploitable, types histologiques et résultats du traitement.
Méthodes: Les données des patients avec insuffisance rénale carcinome baso-cellulaire a été récupéré de la division Urologie audit livre, théâtre registres et fichiers des dossiers du service des archives médicales et à la pathologie s’inscrire dans le département de pathologie. Les paramètres étudiés étaient l’âge, le sexe, le motif de la présentation, le nombre de patients qui ont subi une intervention chirurgicale, l’histologie types et au résultat du traitement.
Résultats: Au total, il y avait 69 patients avec insuffisance rénale carcinome baso-cellulaire qui représentaient 59,5 % de toutes les masses rénale vu. Le rapport entre hommes et femmes était de 1:1. Leur âge variait de 16 à 88 avec une moyenne de 48 ans et la médiane de 50 ans. La principale fonctionnalité clinique était aloyau enflure (100 %) et d’autres ont été aloyau douleur(29 % ),hématurie (18.8 %), une perte de poids (4 %) etsyndromes neurologiques paranéo- plasiquessyndrome (anaémie sanshématurie) a été observée dans 2,9 %. Dix pour cent des cas avait la triade classique d’hématurie, aloyau douleur et aloyau enflure. Tous les cas étaient unilatérales maladie et 15 ( 21,7 %) avaient les métastases à la présentation. Le pré-opératoires essais étaient échographie abdominale (94 % ), intraveineuse urographie par rm (45 %) et CT-Scan (11.6 % ). Vingt-huit patients ( 40,6 %) avaient une chirurgie dont 5 étaient non résécables. 37 Des patients ( 53,6 %) ont été perdus par la suite de suivre. Les 28 coopératives spécimens ont été confirmée histologiquement et 85,7 % étaient claires carcinome baso-cellulaire. Les 23 patients dont les tumeurs étaient spécimen tumoral prélevé (corrélé sont restés indemnes, certains jusqu’à 5 ans. Cependant les cinq patients avec tumeurs non résécables sont décédés entre 3 à 6 mois de chirurgies exploratoires.
Conclusion: Les patients avec resectable tumour pourrait rester exempte de maladie pour une période significative après malgré présentation tardive. Toutefois, il existe une forte perte de taux de suivi.
Correspondence: Dr. Augustine O. Takure, Department of Surgery, University College Hospital, PO Box 5116, Ibadan, Nigeria. E-mail: aotakure@yahoo.com; augusturoendo@gmail.com
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