Ján Kliment
Aim: To provide information on etiological factors, diagnosis, treatment and histopathological findings in patients with renal cell carcinoma enrolled in the register of clinical renal carcinomas in 2011. Materials and Methods: Clinical data were analysed in 743 patients with renal cell carcinoma who were treated in 17 different departments of urology in Slovakia in the period from 1 Jan 2011 to 31 Dec 2011. We evaluated demographic data, disease symptoms, diagnostic methods, distribution of clinical stages of the disease, surgical techniques and approaches used in the treatment of diseases and histological types. Data analysis was performed using standard descriptive statistics output - using pivot tables for qualitative variables and using the mean, standard deviation, median, minimum and maximum values for quantitative variables. Results: Out of 743 patients 63 % were men and 37 % women. Obesity has been reported in 30 % and 39 % of overweight patients. Hypertension was treated in 72 % of patients. Smoking was reported in 22 % of patients. In the diagnostics, the most commonly used method was computed tomography in 93 % of patients, and sonography in 86 % of patients. Kidney cancer was diagnosed incidentally in 67 % of patients. The clinical stages of disease were seen in T1 stage in 45 % of patients, in T2 stage in 7.4 %, T3 stage in 10.2 %, and T4 stage in 19.2 % of patients. The most common site of metastasis was seen in the lungs and lymph nodes. 64 % of patients underwent radical nephrectomy and 20 % of patients underwent nephron-sparing surgery. The transperitoneal approach in nephrectomy was used in 42 % of patients, 37 % of patients underwent lumbotomic approach. Laparoscopic transperitoneal nephrectomy was performed in 16 % of patients. Nephrectomy associated with the removal of thrombus from the inferior vena cava was performed in 6 % of patients, adrenalectomy in 14 % and a regional lymph node dissection was performed in 12 % of patients. Conventional clear cell carcinoma was diagnosed in 83 %, papillary I type in 4.1 %, II type in 4.1 %, chromophobe in 2.2 % and sarcomatoid undifferentiated tumour in 1.9 %. The second histological grade of malignancy was present in 45 % and the third stage in 30 % of patients. Treatment of advanced disease using tyrosine kinase inhibitors is recommended in 15 % of patients.Conclusion: Data analysis from clinical registries of renal cell carcinoma has provided a picture of ethiopathogenetic and demographic factors, diagnostics and treatment of kidney cancer in Slovakia. It also provided suggestions how to improve the further care of patients with renal cell carcinoma.