RADICAL NEPHRECTOMY IN THE MANAGEMENT OF LOCALIZED RENAL CELL CARCINOMA

Background: Renal cell carcinoma is the 7th most common cancer among men and 12th among females. This study was undertaken to share our experience regarding the outcome of radical nephrectomy in the management of localized renal cell carcinoma. Material Methods: This cross-sectional study was carried out at the Department of Urology, Lady Reading Hospital, Peshawar, Pakistan from January 2005 to December 2009. A consecutive sample of 150 patients with localized renal cell carcinoma scheduled for radical nephrectomy was included. Patients with age more than 75 years, chronic renal failure and other significant co-morbid diseases were excluded. All these patients underwent transperitoneal radical nephrectomy through subcostal/ hemi-chevron incision. Resected tumors were sent for histopathology. All these patients were followed for five years. Sex and age in years were demographic variables. Mode of presentation, laterality, hemoglobin level, per op complications, post op complications, blood transfused, surgical time, tumor size, specimen weight, and hospital stay were research variables. Results: Out of the 150 patients, 100 (66.66%) were males and 50 (33.33%) were females. Mean age was 56 (35-68) years. The laterality of tumor was left in 87 (58%) and right in 63 (42%) cases. Mode of presentation was classic triad of pain in flank, palpable mass and hematuria in 12 (8%), pain in flank in 40 (26%), palpable mass in 8 (5.33%), hematuria in 20 (13.33%), and non-specific symptoms in 70 (46.66%) patients. Conclusion: Renal cell carcinoma is a disease of the elderly with a male predominance. Radical nephrectomy for localized disease is the treatment of choice