Clinocopathological Features of Renal Cell Carcinoma seen at a Radiotherapy Centre in Ibadan, Nigeria

Abstract

Renal cell carcinoma (RCC) is a rare but lethal disease that accounts for about 2-3% of all adult malignancies. Reports from developing countries indicate a rising incidence while studies in our environment are sparse. The aim of this study is to determine the prevalence, pattern of presentation and outcome of treatment of patients with RCC seen at the Radiotherapy Clinic of the University College Hospital Ibadan. A 25 year retrospective study of patients treated for RCC was conducted. Case file records were retrieved and information on patients’ socio demographic data, presentation pattern, histology, treatment received and outcome of treatment were extracted. A total of twenty four (24) patients were seen within this period. A higher percentage of patients were female (62.5%) while males accounted for only 37.5%. The mean patient age was 42.9 years. Hematuria, loin pain and flank mass accounted for 80%, 37.5% and 28% of the presenting complaints respectively. Only 12.5% of patients presented with the classic triad of hematuria, loin pain and flank mass. Majority of the patients (62.5%) presented with advanced metastatic diseases. The commonest site of metastasis was the spine (29.2%). About two-third (67%) of patients had surgery. All patients had radiotherapy; 50% to the primary sites, 37.5% to metastatic sites and 12.5% to both metastatic and primary sites. All patients who presented with metastasis had chemotherapy. Only 4 patients (17%) were disease-free at the end of the first year post
treatment while only 1 was reported dead. The rest were either lost to follow-up (42%) or referred for palliative care (25%) as a result of disease progression. Renal cell carcinoma is a rare malignancy in Nigeria and patients often present late. Physicians working in this region needs to have high index of suspicion to diagnose the disease early as the outcome of treatment in late cases is poor.