Abstract
Questionnaires were sent to 1, 673 dialysis units, transplant centers, and urological departments in Japan in February 1986, to determine the present status of renal adenocarcinoma in chronic hemodialysis patients. The response rate of 73.7% covered about 70% of the 66, 310 dialysis patients in Japan. Renal cell carcinomas were found in 48 dialysis patients between March 1984 and February 1986. The mean age of the 48 patients (40 males and 7 females) was 50.5±10.0 (mean±S. D.) years. The mean duration of dialysis was 83.9±45.2 months. The clinical diagnosis of adenocarcinoma was based on CT (24 cases) and sonographic examination (6 cases). The adenocarcinomas were found at autopsy in 9 cases. The original kidney disease was chronic glomerulonephritis in 32 cases and polycystic kidney disease in 4. Uremic acquired cystic disease was found in 39 of 48 adenocarcinomas. Curative nephrectomy was performed in 22 of 48 patients. The mean diameter of the renal cancer was 5.4±3.8 (0.5-15.0)cm.
However, 10 of 48 patients had metastasis. All 10 patients were male; their mean age was 52.6±7.8 years, mean duration of dialysis 98.3±37.8 months and tumor size 6.3±3.7 (1.2-14.0)cm in diameter. Acquired cystic disease was found in 8 of 10 metastatic adenocarcinomas.
In conclusion, renal adenocarcinoma associated with dialysis cannot be regarded as benign, as 10 of 48 patients (20.8%) had metastasis.
