Development of renal cell carcinoma (RCC) diagnostics and impact on prognosis
- To evaluate imaging methods and prognoses between small renal cell carcinomas (RCCs) and larger tumours according to the era of diagnostics.
Patients and Methods
- In all, 784 consecutive patients diagnosed with RCC between 1964 and 1997 at the Pirkanmaa Hospital District in Finland were included.
- Patients were divided into two groups: tumours of ≤3.0 and >3.0 cm in diameter.
- Prognosis was analysed according to the era of diagnostics: (i) pre-computed tomography (CT) and pre-ultrasound (US), (ii) US era and (iii) CT era.
- Small tumours became more common: in the pre-CT and pre-US era, only 4.4% of tumours were small; however, in the CT era 16% were small tumours.
- More diagnostic methods were used in studying small tumours.
- CT proved to be the most reliable method, although it was actually better at diagnosing large tumours.
- Relapses occurred less frequently among patients with small tumours; more than half of the tumours that developed distant metastases (16.0%) already evinced them at the time of diagnosis. There were no relapses after 14 years of follow-up among small tumours, whereas large tumours relapsed within that time. RCC was the cause of death in 14.9% of patients with small tumours vs 50.7% with large tumours.
- The best prognosis was among patients with small tumours diagnosed with CT.
- Among patients with small tumours, prognosis has improved along with better diagnostics, although some showed relapse during a surveillance period of up to 14 years.