Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

Article Information

Title: Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

Authors: Mohammad Roman, Bilal Habib, khursheed Anwar

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2022

Volume: 72

Issue: 5

Language: English

DOI: 10.51253/pafmj.v72i5.8046

Keywords: Renal cell carcinomaClear cell carcinomaFuhrman gradeRenal vein thrombosis

Abstract

Objective: to identify the demographic, laboratory, radiological and histological features of RCC patients presenting to a tertiary care hospital in Islamabad.
Study Design: Cross-sectional study.
Place and Duration of Study: Pakistan Atomic Energy Commission General Hospital, Islamabad Pakistan, from Jan 2014 to Aug 2021.
Methodology: All the patients who underwent radical nephrectomy for histologically confirmed RCC at PAEC General Hospital Islamabad were included in the study. Demographic variables, ultrasound features, laboratory measures, histological types and Fuhrman grading were noted.
Results: A total of 65 consecutive patients were included, which included 38(58.5%) males. The mean age of the patients was 52.6±8.6 years. The most common symptom was flank pain (42.2%). The diagnosis was made incidentally in 26 patients. The most common ultrasound feature was capsule involvement (23, 35.3%), and most cases were Fuhrman Grade-II (22, 48.9%). On histology, clear cell carcinoma was the most common RCC (40, 61.5%). Post-operative early RFT deterioration was noted in 32(49.2%) patients. This was significantly associated with greater tumour size, Fuhrman Grade-III/IV, renal vein thrombosis, gerota fascia, and ureteric involvement. There was no mortality in our study during the admission days until discharge.
Conclusion: Renal cell carcinoma was more common among males and at a later stage of life (5th decade). The most common type was clear cell carcinoma. Post-operative early RFT deterioration was noted in 49.2% of patients. It was associated with greater tumour size, Fuhrman Grade III and IV, renal vein thrombosis, gerota fascia, and ureteric involvement.&nbsp;

Disclaimer: The following sections are produced through an intensive multi-stage analytical pipeline developed by DefinePK, utilizing advanced natural-language processing, domain-specific knowledge models, and automated cross-referencing systems. Despite the rigor and computational effort involved, the generated summary may still contain inaccuracies or incomplete interpretations. Users are strongly advised to verify all critical information against the original paper and its authoritative sources.

Research Objective

To identify the demographic, laboratory, radiological, and histological features of Renal Cell Carcinoma (RCC) patients presenting to a tertiary care hospital in Islamabad.

Methodology

Cross-sectional study conducted at Pakistan Atomic Energy Commission General Hospital, Islamabad, from January 2014 to August 2021. Data from patients who underwent radical nephrectomy for histologically confirmed RCC were collected from hospital medical records. Variables included demographic data, ultrasound features, laboratory measures, histological types, and Fuhrman grading. Statistical analysis was performed using SPSS version 23.0.

Methodology Flowchart

                        graph TD
    A["Data Collection from Hospital Records"] --> B["Data Analysis using SPSS v23.0"];
    B --> C["Identify Demographic, Lab, Radiological, Histological Features"];
    C --> D["Analyze Associations with RFT Deterioration"];
    D --> E["Formulate Conclusions"];

Discussion

The study highlights that RCC is more prevalent in males and in the fifth decade of life, with clear cell carcinoma being the most common subtype. The high incidence of incidental diagnoses (40%) suggests improved imaging modalities. Post-operative RFT deterioration is a significant concern, linked to advanced tumor characteristics. The findings are compared with international and regional studies, noting similarities in epidemiological trends and histological types, but also differences in incidental diagnosis rates and perinephric involvement, potentially due to late presentation in the local context.

Key Findings

- A total of 65 patients were included, with 58.5% being male.
- The mean age was 52.6±8.6 years.
- The most common symptom was flank pain (42.2%), and 40.0% of diagnoses were incidental.
- Clear cell carcinoma was the most common histological type (61.5%).
- Post-operative early renal function test (RFT) deterioration was noted in 49.2% of patients.
- RFT deterioration was significantly associated with greater tumor size, Fuhrman Grade-III/IV, renal vein thrombosis, Gerota fascia involvement, and ureteric involvement.
- No mortality was observed during the admission days until discharge.

Conclusion

Renal cell carcinoma is more common in males and in the fifth decade of life, with clear cell carcinoma being the predominant type. Post-operative renal function deterioration occurs in nearly half of the patients and is associated with larger tumor size, higher Fuhrman grades, and specific local invasion patterns.

Fact Check

- Number of patients: 65 consecutive patients were included in the study. (Confirmed in Results section)
- Percentage of males: 58.5% of the included patients were male. (Confirmed in Results section)
- Post-operative RFT deterioration: Noted in 49.2% of patients. (Confirmed in Results and Conclusion sections)

Mind Map

Loading PDF...

Loading Statistics...

DefinePK

Select Collection