Background: The aim of this study was to compare outcomes in patients presenting with incidental renal cell carcinoma (RCC), symptomatic RCC and paraneoplastic syndromes in RCC.
Methods: From October 1982 to June 2001, 312 patients with RCC were retrospectively enrolled. The patients were classified as: 1) incidental group: the patients without symptoms whose tumor was discovered incidentally; 2) symptomatic group: the patients presenting symptoms related to renal tumor; 3) paraneoplastic syndrome group: patients whose tumors were associated with paraneoplastic syndromes. Log rank testing was used to analyze statistical differences in the survival period among the three groups.
Results: The distribution of each group was 25.6% (n = 80) in group 1, 55.8% (n = 174) in group 2 and 18.6% (n = 58) in group 3. The mean tumor size was 5.0 cm in group 1, 7.5 cm in group 2 and 8.3 cm in group 3 (p < 0.0001). The incidence of earlier stage (stages I and II) was 80% in group 1, 40.2% in group 2 and 15.5% in group 3 (p < 0.0001). The 10-year survival rate for group 1 patients was 68.6%, for group 2 patients was 45.6% and for group 3 patients was 12.3% (p < 0.0001).
Conclusions: The incidental RCCs were smaller in size and at a lower tumor stage than symptomatic tumors. The paraneoplastic syndromes in patients with RCCs had a grave prognosis. The symptoms of a patient with RCC can be used as a prognostic factor related to survival.