Gudbjartsson T, Einarsson G V, Magnusson J
Laeknabladid. 1994 Feb;80(2):49-56.
Incidence and mortality of renal cell carcinoma (RCC) is very high in Iceland. Studies have shown increased incidence of incidentally diagnosed RCCs. The significans of incidental diagnosis relating to survival of RCC patients is not known. A retrospective population-based study was carried out on all patients diagnosed with RCC between 1971 and 1990 in Iceland. The aim of the study was to evaluate survival of RCC patients in Iceland with emphasis on incidental diagnosis. By incidental diagnosis we mean tumours that were detected due to imaging techniques or an operation for other than RCC symptoms or signs. Of 236 males and 172 females diagnosed, 308 patients underwent radical nephrectomy with operative mortality of 2.6%. The tumours were classified and staged by Robson's method. Crude probability of survival was evaluated for every stage and multivariate analysis used to find prognostic factors. 224 patients presented with symptoms, the most common of which were abdominal pain, hematuria and weight loss. Between 1971 and 1980 15% of the patients were diagnosed incidentally and 20% between 1981 and 1990 (p>0.1), most often because of intravenous urography. Only 5 tumours were detected by ultrasound and 4 by CT-scans. Five year survival was 76% for stage I and 11% for stage IV. Advanced age, low haemoglobin and high ESR at diagnosis are significant independent risk factors of mortality in multivariate analysis. The year of diagnosis is not a significant prognostic factor after correction for stage. Survival of RCC patients in Iceland is comparable to that in neighbouring countries. Patients diagnosed incidentally have better survival because of a lower stage. The use of ultrasound and CT-scans has not significantly increased incidentally diagnosed tumours. Survival has remained the same for the last two decades.
冰岛的肾细胞癌（RCC）发病率和死亡率非常高。研究表明，偶然诊断出的RCC发病率有所增加。偶然诊断与RCC患者生存率之间的关系尚不清楚。对1971年至1990年间在冰岛被诊断为RCC的所有患者进行了一项基于人群的回顾性研究。该研究的目的是评估冰岛RCC患者的生存率，重点是偶然诊断。我们所说的偶然诊断是指由于成像技术或因非RCC症状或体征而进行的手术检测到的肿瘤。在236名男性和172名女性被诊断出的患者中，308例患者接受了根治性肾切除术，手术死亡率为2.6%。肿瘤采用罗布森方法进行分类和分期。评估了每个阶段的粗生存率，并使用多变量分析来寻找预后因素。224例患者出现症状，最常见的症状是腹痛、血尿和体重减轻。在1971年至1980年间，15%的患者是偶然诊断出来的，在1981年至1990年间为20%（p>0.1），最常见的原因是静脉肾盂造影。只有5个肿瘤通过超声检测到，4个通过CT扫描检测到。I期患者的五年生存率为76%，IV期为11%。在多变量分析中，诊断时的高龄、低血红蛋白和高血沉率是死亡率的重要独立危险因素。在校正分期后，诊断年份不是一个重要的预后因素。冰岛RCC患者的生存率与邻国相当。偶然诊断出的患者由于分期较低，生存率更高。超声和CT扫描的使用并没有显著增加偶然诊断出的肿瘤。在过去二十年中，生存率保持不变。
