Second Primary Renal Cell Carcinoma With Nonrenal Malignancies: An Analysis of 118 Cases and a Review of Literature

Jinchao Chen; Nienie Qi; Hua Wang; Zongping Wang; Yedie He; Shaoxing Zhu

doi:10.3389/fonc.2021.780130

Second Primary Renal Cell Carcinoma With Nonrenal Malignancies: An Analysis of 118 Cases and a Review of Literature

Front Oncol. 2021 Nov 25:11:780130. doi: 10.3389/fonc.2021.780130. eCollection 2021.

Authors

Jinchao Chen¹, Nienie Qi², Hua Wang¹, Zongping Wang¹, Yedie He¹, Shaoxing Zhu¹

Affiliations

¹ Department of Urologic Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China.
² Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

Abstract

Objectives: To evaluate the nature, diagnosis, treatment and prognosis of second primary renal cell carcinoma (SPRCC).

Materials and methods: We retrospectively collected data from 118 patients with SPRCC. Clinical characteristics, imaging features and treatments were analyzed and comparisons between SPRCC and renal metastases (RM) were made.

Results: SPRCC accounts for 11.4% of all RCC. The most common types of extrarenal malignancies included lung, colorectal, breast and gynecological cancers. The median age was 58.5 years old, and 61.0% (72/118) of the patients were male. About 5.1% of the patients presented with symptoms. The average tumor diameter was 4.4 cm (1-8.4 cm). The diagnostic specificity of enhanced computed tomography (CT) was 80.1%. When comparing with RM, more patients with stage I-II extrarenal malignancy and less patients with bilateral, multiple, and endogenic renal masses on computed tomography were found in the SPRCC group. A total of 110 SPRCC patients underwent surgery, including 48 radical nephrectomies and 62 partial nephrectomies. The median overall survival time was 117 months. Female, asymptomatic status, no distant metastasis, and surgical treatment predicted a better survival.

Conclusions: SPRCC are not uncommon, and it should be considered during the follow-up of patients with nonrenal malignancy. The differential diagnosis between SPRCC and RM was mainly based on imaging and puncture biopsy.

Keywords: diagnosis; multiple primary malignancy; renal cell carcinoma; renal metastases; treatment.