- Volume 14 Issue 12
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Clinical Prognostic Factors and Survival Outcome in Renal Cell Carcinoma Patients - A Malaysian Single Centre Perspective
- Yap, Ning Yi (Department of Surgery, University of Malaya) ;
- Ng, Keng Lim (Department of Surgery, University of Malaya) ;
- Ong, Teng Aik (Department of Surgery, University of Malaya) ;
- Pailoor, Jayalakshmi (Department of Pathology, University of Malaya) ;
- Gobe, Glenda Carolyn (Centre for Kidney Disease Research, University of Queensland) ;
- Ooi, Chong Chien (Department of Surgery, University of Malaya) ;
- Razack, Azed Hassan (Department of Surgery, University of Malaya) ;
- Dublin, Norman (Department of Surgery, University of Malaya) ;
- Morais, Christudas (Centre for Kidney Disease Research, University of Queensland) ;
- Rajandram, Retnagowri (Department of Surgery, University of Malaya)
- Published : 2013.12.31
Background: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms. Materials and Methods: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis. Results: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses,
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