Alawad Saud Abdullah, Alghamdi Mohammed Hasen, Alharbi Mohammed Ghazi, Addar Abdulmalik, Al Khayal Abdullah M, Alasker Ahmed
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Urol Ann. 2022 Jan-Mar;14(1):15-20. doi: 10.4103/ua.ua_14_21. Epub 2021 Dec 28.
The incidence of renal cell carcinoma (RCC) in young adults has started to increase in recent years.
The objective of the study was to describe and compare the mode of presentation, incidence, risk factors, histopathological features, nephrectomy modalities used, and outcome in patients diagnosed with RCC below the age of 50.
A total of 139 confirmed RCC patients diagnosed below the age of 50 years who underwent nephrectomy from January 1990 to April 2019 were included in this retrospective review. We compared the characteristics of two age groups (≤40 years and 41-50 years) and evaluated incidentally discovered versus symptomatic tumors in patients below 50 years.
Loin pain contributed to most symptomatic presentations in the older group (55%) ( = 0.014). Hypertension and diabetes were present in 24% of patients from 41 to 50 years of age versus 3.8% for hypertension and 5.7% for diabetes in the young group. ( = 0.001 and = 0.004, respectively). Chromophobe was the second most common pathology (26.5%). Tumor size tended to be larger in the older group ( = 0.006). Fuhrman's grade was significantly lower in incidentally diagnosed patients (88.2%) ( = 0.006). The T stage was significantly lower in the incidental group ( = 0.005), but the mortality rate was higher in symptomatic patients (9.6%) ( = 0.013).
RCC increases after the age of 40-50 years in the presence of other risk factors. Chromophobe represented almost a quarter percentage of the pathology, while partial nephrectomy yielded a better outcome.
近年来,年轻成年人肾细胞癌(RCC)的发病率开始上升。
本研究的目的是描述和比较50岁以下确诊为RCC患者的临床表现模式、发病率、危险因素、组织病理学特征、所采用的肾切除术方式及预后。
本回顾性研究纳入了1990年1月至2019年4月期间接受肾切除术的139例确诊为50岁以下的RCC患者。我们比较了两个年龄组(≤40岁和41 - 50岁)的特征,并评估了50岁以下患者中偶然发现的肿瘤与有症状肿瘤的情况。
腰痛是老年组大多数有症状表现的原因(55%)(P = 0.014)。41至50岁的患者中有24%患有高血压和糖尿病,而年轻组中高血压为3.8%,糖尿病为5.7%。(分别为P = 0.001和P = 0.004)。嫌色细胞癌是第二常见的病理类型(26.5%)。老年组的肿瘤大小往往更大(P = 0.006)。偶然诊断的患者中Fuhrman分级显著更低(88.2%)(P = 0.006)。偶然发现组的T分期显著更低(P = 0.005),但有症状患者的死亡率更高(9.6%)(P = 0.013)。
在存在其他危险因素的情况下,40 - 50岁以后RCC发病率增加。嫌色细胞癌占病理类型的近四分之一,而部分肾切除术产生更好的预后。