Renal cancer in Maiduguri: an 8-year review of clinico-pathological pattern

Abstract

Background: Primary renal cancer accounts for 10 – 20% of all genito-urinary tract malignancies. The present study determined its clinico-pathological pattern and outcome of management. Methods: All patients with malignancies of the kidney seen between January 1999 and December 2007 were included in the study. These patients had surgery alone or in combination with preoperative/postoperative chemotherapy or radiotherapy and all specimens were confirmed malignant on histopathological examination. Results: Forty-nine patients with renal malignancies were seen of which 26(55.1%) were males and 23(44.9%) were females. The adults comprised 30(61.2%) and children 19(38.8%). The mean age was 27.60 +/- 22.12 years (range 7months-70 years). The male: female ratio was 1.1:1 and the mean duration of symptoms was 12.56 months (range 1-48 months). The most frequent clinical features were loin pain, 17 (44.7%), and flank mass, 32(84.2%). Others included haematuria, 13(34.2%), fever, 19(50.0%) and anaemia, 15(39.5%). The main diagnostic investigations were ultrasonography and intravenous urography. Forty-seven (95.9) patients underwent radical unilateral nephrectomy and 2(4.1%) had debulking or lymph node biopsies because of non-resectable tumours. These two had chemotherapy and subsequent nephrectomy. The most frequent renal malignancy was renal cell carcinoma (44.9%) followed by nephroblastoma (38.8%) which accounted for all the childhood renal tumours. All the children with nephroblastoma had postoperative 17(89.5%) or preoperative 2(10.5%) combination chemotherapy. Common postoperative complications included anaemia, fever, and chest and wound infections. There were 3 known deaths (mortality rate of 6.1%). The main cause of death was advanced malignancy. Conclusions: Renal cell carcinoma is the most frequent malignant tumour of the kidney in the study population. Late presentation resulted in in-operable tumours with poor survival despite neo-adjuvant chemotherapy.

Keywords: Renal cancer, diagnosis, management, outcome