Renal cell carcinoma: the experience of Kuwait Cancer Control Center, Kuwait.

OBJECTIVES This retrospective study was undertaken to analyze the profile of patients presenting with renal cell carcinoma (RCC) and treatment outcomes. SUBJECTS AND METHODS Records of 49 patients (36 male, 16 female, 21-75 years) treated at the Kuwait Cancer Control Center, Kuwait for RCC during the period 1993-1998 were analyzed. Forty-one patients had a nephrectomy, 18 postoperative radiotherapy and 1 patient also received adjuvant immunotherapy with interferon. Patients with metastatic disease were treated with a variety of agents including interferon, chemotherapy (vinblastine) or a hormonal agent (megestrol acetate). Data analysis was performed using SPSS statistical software package. Overall survival and disease-free survival were calculated using the Kaplan-Meier method. RESULTS Twenty-nine patients presented with symptoms classically associated with RCC. Metastases at diagnosis were seen in 9 patients (18%), with lung being the most frequent site. The commonest tumor subtype was clear cell carcinoma (32.6%). Thirty-nine patients (80%) achieved a complete response to treatment and relapse was documented in 10 patients (26%). The majority of failures were distant, with lung metastases being the most common. Response to salvage treatment was poor. Overall survival was 83% at 2 years. The disease-free survival was 68 and 45% at 2 and 5 years, respectively. CONCLUSIONS Although many patients presented with advanced local disease, a majority achieved complete response after radical surgery with or without postoperative radiation therapy. Salvage of metastatic disease proved difficult with interferon, chemotherapy.