A quarter of patients who develop renal cell
carcinoma will have metastatic disease at
presentation. The role of cytoreductive surgery in
these patients is a topic of debate. The aim of this study was to analyse
survival outcomes of patients treated in Malta who
did and did not receive a nephrectomy.
Data was gathered retrospectively from the
Malta Cancer Registry and Mortality Data at the
Department of Health Information, records of
multidisciplinary team meetings held within the
urology department at Mater Dei Hospital, hospital
imaging and patient records. Data gathered
included: patient demographics, date of diagnosis,
TNM staging, tumour histology, Fuhrman grade,
time to treatment and modality of treatment.
Exclusions included:
• Localized disease relapsing after surgery
• Non-renal cell histological subtypes
• Presence of metastasis at diagnosis not certain
• Concomitant primary tumours
77 patients diagnosed over 5 years between
04.03.2005 and 13.2.2009 were included. The age
at presentation ranged from 30 to 88 years, with a
median age of 67 years. 11 were incidental findings
and 47 were symptomatic. The most prevalent
symptoms were abdominal pain and gross
haematuria.
Five-year cancer specific survival in patients
who received a nephrectomy was significantly
better at 65%, compared to patients who did not
undergo surgery (32%) P value <0.05, CI 95%.
These results where compared favourably with
SEER data outcomespeer-reviewe
