Abstract
In February 2002, 3, 155 questionnaires were sent to dialysis units and urological departments in Japan to survey the incidence and recent trends in renal cell carcinoma among dialysis patients diagnosed between March 2000 and February 2002. Four hundred eighty-nine renal cell carcinomas (381 in males, 104 in females and not indicated in 4) were reported in this survey. Mean age of renal cell carcinoma patients was 57.5±11.4 (mean±SD) years old, and the mean duration of dialysis was 136.9±95.2 months. Renal cell carcinoma was detected by symptoms alone in 5.3% of cases, by sonographic screening in 46.1% and CT scan in 44.2%. The metastasis rate was 15.2%. Renal cell carcinomas were complicated by acquired renal cysts in 80.7%. Outcome was “alive without cancer” in 74.1%, “cancer death” in 6.4% and “death from other diseases” in 4.1%. Histologically, clear cell carcinoma was found in 56.3%, granular cell carcinoma in 18.1%, papillary renal cell carcinoma in 15.0%, cyst-associated renal cell carcinoma in 7.0% and spindle cell carcinoma in 3.1%. Among questionnaire studies conducted over the 20 years, the mean age of dialysis patients overall increased by 14.1 years. However, the mean age of dialysis patients with renal cell carcinoma increased by only 7.8 years, indicating that renal cell carcinoma in dialysis patients tends to develop in younger dialysis patients. In conclusion, the number of renal cell carcinomas in this questionnaire study was larger than those in 10 previous questionnaire studies. Furthermore, 54.6% of renal cell carcinoma patients had received more than 10 years of dialysis, while 17.7% had received more than 20 years of dialysis.
