Tumour characteristics and surgical treatment of renal cell carcinoma in Sweden 2005–2010: a population-based study from the National Swedish Kidney Cancer Register

Abstract

Objective. Tumour characteristics, preoperative work-up and surgical treatment in patients diagnosed with renal cell carcinoma (RCC) between 2005 and 2010, and changes over time were studied in a national population-based cohort. Material and methods. The National Swedish Kidney Cancer Register (NSKCR) contains information on histopathology, Fuhrman grade and clinical stage at presentation, and on the preoperative work-up and surgical treatment of patients with RCC. Between 2005 and 2010, 5553 RCC patients were registered in the NSKCR, 99% of those registered in the National Cancer Registry. Results. During the study period the mean tumour size decreased from 70 to 64 mm (p = 0.024) and the frequency of metastatic RCC decreased from 22% to 15% (p < 0.001). The use of preoperative chest computed tomography increased from 59% to 84%. In total, 4229 (76%) patients were treated with curative intent, 3453 (82%) underwent radical nephrectomy, 606 (14%) partial nephrectomy (PN) and 170 (4%) cryotherapy or radiofrequency ablation. In tumours up to 4 cm, PN was performed in 33% of the surgically treated patients. PN irrespective of size increased from 8% to 20% and laparoscopic nephrectomy increased from 6% to 17% during the period. In patients with metastatic RCC, 55% underwent cytoreductive nephrectomy. Conclusions. The NSKCR explores population-based data on the clinical handling of patients with RCC. This study, between 2005 and 2010, shows significant decrease in tumour size and metastatic RCC at presentation, a more complete preoperative work-up, and significantly increased use of PN and laparoscopic nephrectomy in Sweden.

Key Words::

• distant metastasis
• lymph-node metastasis
• population-based
• renal cell carcinoma
• survival
• tumour category
• tumour size

Acknowledgements

This study was supported by grants from the Research Foundation at the Urology Department of Sahlgre-nska University Hospital, the Foundation of Anna-Lisa and Bror Björnsson, the Swedish Research Council (825-2008-5910), the Stockholm Cancer Society and the Troell scholarship of S:t Görans Hospital. The National Swedish Kidney Cancer Register is supported by Stockholms kommuner och landsting (SKL). Valerie and David Major made important linguistic contributions.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.