Renal cell carcinoma in a semi-urban population of south-western Nigeria
AbstractObjective: To describe the demographic features, treatment challenges and prognosis of renal cell carcinoma (RCC) in a semi-urban population of south-western Nigeria
Design: A retrospective review of RCC managed between January 2007 and December 2014
Setting: Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, southwestern Nigeria
Subjects: Fifty-one patients with histologically confirmed RCC Interventions: Radical nephrectomy, Immunotherapy
Main outcome measures: Surgical outcomes
Results: A total of 51 cases were reviewed, representing 46.8/100,000 of all new patients. Age range was 21 to 83 years, with peak in third decade and male to female ratio of 1:1.5. Identified risk factors were systemic hypertension (15.7%), smoking (11.8%) and obesity (3.9%). Triad of haematuria, loin pain and loin mass was found in 13.7% while 5.9% were discovered incidentally. The right and left kidneys were involved in 41.2% and 58.8% respectively. Radical nephrectomy was the most common procedure done (78.4%). Surgical complications included excessive primary haemorrhage (8.5%), surgical site infection (6.4%) and duodenal injury (2.1%) while mortality was (2.1%). Adjuvant immunotherapy with sunitinib/sorafenib was given in 7.8% of patients. The histologic types were clear cell (60.8%), chromophobe (17.6%), papillary (13.7%), sarcomatoid (3.9%), mixed (1.9%) and multilocular cystic RCC (1.9%). Clear cell variant were low grade with good prognosis. Poor prognostic factors were sarcomatoid histology and late presentation
Conclusion: RCC is more common in females mainly of the younger age group in our environment. Radical nephrectomy remains the mainstay of management, including in advanced cases.