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Favorable Survival for Incidental Renal Cell Cancer Detection

Incidentally diagnosed tumors diagnosed at lower stage and grade, and at smaller size

TUESDAY, Dec. 20 (HealthDay News) -- Patients with incidentally diagnosed renal cell carcinoma have improved survival compared with those who have symptomatic tumors, according to a study published in the January issue of The Journal of Urology.

Helga Bjork Polsdottir, from Landspitali University Hospital in Reykjavik, Iceland, and colleagues investigated the prognostic factors of survival for renal cell carcinoma, focusing on the effect of incidental detection. All 910 living patients diagnosed with renal cell carcinoma in Iceland between 1971 and 2005 were included, and data from their hospital charts and histology were reviewed. Renal cell carcinomas diagnosed incidentally were compared with symptomatic tumors.

The investigators found that 27.9 percent of patients were diagnosed incidentally, usually by abdominal ultrasound and computerized tomography (29.5 and 28.3 percent, respectively). From 1971-1975 to 2001-2005, there was a significant increase in the incidental detection rate, from 11.1 to 39.2 percent. Compared with symptomatic tumors, incidentally detected tumors were diagnosed at a lower stage and grade and were an average of 2.6 cm smaller, with similar age and histology in both groups. Independent and significant prognostic factors of survival included age; calendar year of diagnosis; erythrocyte sedimentation rate; and tumor, node, metastasis stage, which was by far the strongest factor. After adjusting for confounders, worse survival was seen for patients with symptomatic renal cell carcinoma than those diagnosed incidentally.

"In conclusion, incidental detection appears to affect survival favorably and to a greater extent than can be explained by differences in stage, grade, or patient demographics compared to those of patients with symptoms," the authors write.

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