Indian Journal of Surgical Oncology

, Volume 9, Issue 4, pp 558–564 | Cite as

Decadal Experience of Renal Cell Carcinoma from a Tertiary Care Teaching Institute in North India

  • Singh KawaljitEmail author
  • Sinha Rahul Janak
  • Gupta Ashok
  • Singh Vishwajeet
Original Article


To study the current trends of renal cell carcinoma (RCC) in terms of demographic characteristics, clinical presentation, staging, mode of management, histopathology, and survival characteristics from a high volume tertiary care teaching institute in North India. We retrospectively reviewed the records of all patients of RCC between January 2006 and December 2015 and variables like age, gender, symptoms, tumor size/location/number, stage, type of surgery, histopathology, and survival characteristics were studied. One hundred forty-four patients were included in the study. Most common age group of presentation was 50–59 years (29.8%), male to female ratio was 2.5, and majority of cases were smokers. Flank pain was the most common presenting complaint (38.2%), classical triad (pain, fever, hematuria) was present in 25%, and incidental diagnosis was made in 11.1% cases. Stage T2a was most common presentation with majority of tumors present in upper pole (27.1%). Renal vein involvement (T3a) was present in 10.4%, hilar lymph node involvement in 25%, and distant metastasis was observed in 20.1% cases. Radical nephrectomy was most common surgery performed (75%) and clear cell carcinoma was the most common histopathology (75.7%) followed by papillary (11.1%). Women reported more chromophobe type and low-grade cancers, although rest of clinico-pathological features did not show any gender difference. Mean follow-up of the study was 6–122 months with younger (< 29 years) patients reporting lower 5-year survival and higher stage disease. Renal cell carcinoma shows a different trend in our study population, compared to western data, with large size tumors and advanced stage presentation being more common.


Renal cell carcinoma Radical nephrectomy Partial nephrectomy Laparoscopic nephrectomy 



The authors would like to acknowledge their family, friends, and patients for their constant support and motivation in writing this manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    Jemal A, Siegel R, Xu J, Ward E (2010) Cancer statistics, 2010. CA Cancer J 60:277–300CrossRefGoogle Scholar
  2. 2.
    Pantuck AJ, Zisman A, Beldegrun AS (2001) The changing natural history of renal cell carcinoma. J Urol 166:1611–1623CrossRefGoogle Scholar
  3. 3.
    Siegel R, Naishadham D, Jemal A (2013) Cancer statistics, 2013. CA Cancer J Clin 63:11–30CrossRefGoogle Scholar
  4. 4.
    Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7 edition of the AJCC Cancer Staging Manual and the Future of TNM. Ann Surg Oncol 17:1471–1474CrossRefGoogle Scholar
  5. 5.
    Lopez-Beltran A, Scarpelli M, Montironi R, Kirkali Z (2006) 2004 WHO classification of renal tumors of the adults. Eur Urol 49:798–805CrossRefGoogle Scholar
  6. 6.
    Salagierski M, Akdogan B, Brookman May S, Dobrowdska Glazar B, Ficarra V, Langenhuijsen JF et al (2013) What is the contemporary role of radiofrequency ablation in the management of small renal masses? Are small lesions the radiologist’s tumors? Eur Urol 63:493–495CrossRefGoogle Scholar
  7. 7.
    Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr (1999) Rising incidence of renal cell cancer in the United States. JAMA 281:1628–1631CrossRefGoogle Scholar
  8. 8.
    Ferlay J, Soerjomataram I, Ervik M (2014) GLOBOCON 2012, Cancer incidence and mortality worldwide: IARC Cancer base no.11. International Agency for Research on Cancer, LyonGoogle Scholar
  9. 9.
    Hunt JD, Van der Hel OL, McMillan GP, Boffetta P, Brennan P (2005) Renal cell carcinoma in relation to cigarette smoking: meta-analysis of 24 studies. Int J Cancer 114:101–108CrossRefGoogle Scholar
  10. 10.
    Agnihotri S, Kumar J, Jain M, Kapoor R, Mandhani A (2014) Renal cell carcinoma in India demonstrates early age of onset & a late stage of presentation. Indian J Med Res 140(5):624–629PubMedPubMedCentralGoogle Scholar
  11. 11.
    Sun M, Abdollah F, Bianchi M, Trinh Q, Jeldres C, Tian Z et al (2011) A stage for stage and grade for grade analysis of cancer specific mortality rates in renal cell carcinoma according to age: a competing risks regression analysis. Eur Urol 60:1152–1159CrossRefGoogle Scholar
  12. 12.
    Sidharth LBR, Gupta DK, Maskey P, Chalise PR, Sharma UK, Gyawali PR, Shrestha GK, Sayami G, Joshi BR (2011) Pattern of renal cell carcinoma – a single center experience in Nepal. Kathmandu Univ Med J 35(3):185–188Google Scholar
  13. 13.
    Jun C, Zhishun X, Xianzhou J, Qiang F, Jin W (2006) Association between age and clinical characteristics of renal cell carcinoma in adult patients. Int J Urol 13:515–519CrossRefGoogle Scholar
  14. 14.
    Ljungberg B, Campbell SC, Choi HY et al (2011) The epidemiology of renal cell carcinoma. Eur Urol 60:615–621CrossRefGoogle Scholar
  15. 15.
    Kane CJ, Mallin K, Ritchey J, Cooperberg MR, Carroll PR (2008) Renal cell cancer stage migration: analysis of the National Cancer Data Base. Cancer 113:78–83CrossRefGoogle Scholar
  16. 16.
    Alkhateeb SS, Alkhateeb JM, Alrashidi EA (2015) Increasing trends in kidney cancer over the last 2 decades in Saudi Arabia. Saudi Med J 36(6):698–703CrossRefGoogle Scholar
  17. 17.
    Silverman SG, Israel GM, Herts BR, Richie JP (2008) Management of the incidental renal mass. Radiology 249:16–31CrossRefGoogle Scholar
  18. 18.
    Krambeck A, Iwaszko M, Leibovich B et al (2008) Long-term outcome of multiple ipsilateral renal tumours found at the time of planned nephron-sparing surgery. BJU Int 101:1375–1379CrossRefGoogle Scholar
  19. 19.
    Zini L, Destrieux-Garnier L, Leroy X, Villers A, Haulon S, Lemaitre L, Koussa M (2008) Renal vein ostium wall invasion of renal cell carcinoma with an inferior vena cava tumor thrombus: prediction by renal and vena caval vein diameters and prognostic significance. J Urol 179:450–454CrossRefGoogle Scholar
  20. 20.
    Crispen PL, Breau RH, Allmer C, Lohse CM, Cheville JC, Leibovich BC, Blute ML (2011) Lymph node dissection at the time of radical nephrectomy for high-risk clear cell renal cell carcinoma: indications and recommendations for surgical templates. Eur Urol 59:18–23CrossRefGoogle Scholar
  21. 21.
    Négrier S, Escudier B, Gomez F, Douillard JY, Ravaud A, Chevreau C, Buclon M, Pérol D, Lasset C (2002) Prognostic factors of survival and rapid progression in 782 patients with metastatic renal carcinomas treated by cytokines: a report from the Groupe Français d’Immunotherapie. Ann Oncol 13:1460–1468CrossRefGoogle Scholar
  22. 22.
    Chen J, Shi B, Zhang D, Jiang X, Xu Z (2009) The clinical characteristics of renal cell carcinoma in female patients. Int J Urol 16(6):554–557CrossRefGoogle Scholar
  23. 23.
    Conti SL, Thomas IC, Hagedorn JC, Chung BI, Chertow GM, Wagner TH, Brooks JD, Srinivas S, Leppert JT (2014) Utilization of cytoreductive nephrectomy and patient survival in the targeted therapy era. Int J Cancer 134:2245–2252CrossRefGoogle Scholar
  24. 24.
    Aron M, Nguyen MM, Stein RJ, Gill IS (2008) Impact of gender in renal cell carcinoma: an analysis of the SEER database. Eur Urol 54(1):133–140CrossRefGoogle Scholar
  25. 25.
    Schrader AJ, Sevinc S, Olbert PJ, Hegele A, Varga Z, Hofmann R (2008) Gender-specific characteristics and survival of renal cell carcinoma. Urologe 47(9):1182, 1184–6CrossRefGoogle Scholar
  26. 26.
    Elmore JM, Kadesky KT, Koeneman KS, Sagalowsky AI (2003) Reassessment of the 1997 TNM classification system for renal cell carcinoma. Cancer 98:2329–2334CrossRefGoogle Scholar
  27. 27.
    Gupta NP, Ishwar R, Kumar A, Dogra PN, Seth A (2010) Renal tumors presentation: changing trends over two decades. Indian J Cancer 47:287–291CrossRefGoogle Scholar
  28. 28.
    Pierorazio PM, Murphy AM, Benson MC, McKiernan JM (2007) Gender discrepancies in the diagnosis of renal cortical tumors. World J Urol 25(1):81–85CrossRefGoogle Scholar

Copyright information

© Indian Association of Surgical Oncology 2018

Authors and Affiliations

  • Singh Kawaljit
    • 1
    Email author
  • Sinha Rahul Janak
    • 1
  • Gupta Ashok
    • 1
  • Singh Vishwajeet
    • 1
  1. 1.Department of UrologyKing George’s Medical UniversityLucknowIndia

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