The symptoms of renal cell carcinoma related to patients' survival

The aim of this study was to compare outcomes in patients presenting with incidental renal cell carcinoma (RCC), symptomatic RCC and paraneoplastic syndromes in RCC.

From October 1982 to June 2001, 312 patients with RCC were retrospectively enrolled. The patients were classified as: 1) incidental group: the patients without symptoms whose tumor was discovered incidentally; 2) symptomatic group: the patients presenting symptoms related to renal tumor; 3) paraneoplastic syndrome group: patients whose tumors were associated with paraneoplastic syndromes. Log rank testing was used to analyze statistical differences in the survival period among the three groups.

The distribution of each group was 25.6% (n = 80) in group 1, 55.8% (n = 174) in group 2 and 18.6% (n = 58) in group 3. The mean tumor size was 5.0 cm in group 1, 7.5 cm in group 2 and 8.3 cm in group 3 (p < 0.0001). The incidence of earlier stage (stages I and II) was 80% in group 1, 40.2% in group 2 and 15.5% in group 3 (p < 0.0001). The 10-year survival rate for group 1 patients was 68.6%, for group 2 patients was 45.6% and for group 3 patients was 12.3% (p < 0.0001).

The incidental RCCs were smaller in size and at a lower tumor stage than symptomatic tumors. The paraneoplastic syndromes in patients with RCCs had a grave prognosis. The symptoms of a patient with RCC can be used as a prognostic factor related to survival.