WESTPORT, CT (Reuters Health) – Incidentally detected renal cell carcinomas have a better prognosis than those diagnosed after symptoms occur, according to a report in the November issue of BJU International.
While this finding may seem intuitive, several published reports have indicated no significant difference in the stage of these tumors or survival outcomes.
Dr. J. Masood and colleagues, from Harold Wood Hospital in Essex, UK, compared the stages and outcomes of tumors detected incidentally with those of tumors diagnosed after symptoms appeared.
The study included 24 patients in the incidental group and 76 patients in the symptomatic group. Incidental group patients presented with lower urinary tract symptoms but had no symptoms indicative of renal cell carcinoma. The mean followup was 2.5 years.
Sixteen patients in the incidental group and 29 patients in the symptomatic group had organ-confined tumors, the authors note (p < 0.05). The average tumor size of 5.9 cm in the incidental group was significantly smaller than the 9.2 cm average size in the symptomatic group (p < 0.001).
The incidental group experienced a significant survival advantage over the symptomatic group (p < 0.05). This appeared to be related to the smaller tumor size and the lower clinicopathologic stage in the incidental group.
Patient survival is improved when renal cell carcinomas are detected incidentally, the investigators note. "This suggests that opportunities which arise for appropriate screening of the upper tracts during routine urological investigations…should be endorsed, and contrasts with the more traditional approach which argues that it yields no ultimate survival advantage."
BJU Intl 2001;88:671-674.
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