Renal Cancers in Ibadan, Nigeria (2013-2022): An update

Abstract

Background: Renal cancer (RC) is projected to be stable in the developed countries and increase in the developing countries. In the last review in our environment over 5 years; 69 patients had RC, a rise in clear cell carcinoma, tumours in young adults and less use of abdominal CT scan. We present an update of RC in Ibadan. Methods: This was a retrospective study of patients who presented with clinical, imaging studies and histological diagnosis of RC between 2013 to 2022. We analysed these data as well as histology types, treatment offered and outcome of management using Kaplan-Meier survival curve. Results: There were 68 patients with RC, mean age was 49.7±14.8years. Males were 52.9% and 47.1% were females. They presented with pain and total haematuria (20.6%), pain and swelling (19.1%), pain alone (17.6%) and 7.4% had incidental RCs. Abdominal CT scan performed in all that confirmed 98.5% and 1.5% were unilateral and bilateral respectively. Localized and locally advanced renal cancers accounted for 79.4% while 20.6% were metastatic disease. Paraneoplastic manifestations of RC were seen in 57.4%. RC rose gradually and peaked in 2019 and thereafter stabilized. The commonest histological types were clear cell RC (36.9%) and papillary RC (27.9%). Rare RCs were neuroendocrine RC (3.9%) and collecting duct RC (2.0%). The treatments offered were radical nephrectomy (RN), unresectable tumours, and targeted therapy in 72.1%, 13.2%, and 7.4% respectively. The median overall survival (OS) was 37 months (p=0.000, Chi-square 63.413, dt = 3). Conclusion: There was a gradual increase number of RC that later stabilized in the last 2 years of the study. There was increased utilization of CT scan. The majority of the patients presented with locally advanced disease. RN remained the main stay of treatment with best survival rate. Neuroendocrine and collecting duct carcinoma are rare.