Epidemiological Characters of Renal Malignancies in Midland Region of Libya; Single Center Experience (National cancer institute Misrata Libya).

Abstract

Introduction: Renal malignancy accounts for 5% and 3% of all adult malignancies in men and women respectively. Renal cell carcinoma (RCC) forms 85% of all primary renal neoplasms. Some of the reported risk factors for RCC include gender, age and other associated factors such as hypertension by chronic use of diuretics, diabetes, urinary tract infections.

Aims: The aim of this study is to clarify epidemiological and clinicopathological features of malignant renal tumors in central region of Libya.
Methods: From January 2014 to December 2019, 57 patients at National Cancer Institute of Misurata proved histopathologically with renal malignancy are included in this study. Related variables such as patients’ demographic features, clinical presentation, size of tumor and laterality, type of surgery, type of chemotherapies and metastatic status were collected from the medical records and pathology reports. All variables were analyzed using the software of “Statistical Package for the Social Sciences†(SPSS), version 20.

Results: In total, 57 patients were diagnosed with renal malignancy, 31 were females (54.5%) and 26 were males (45.6 %) and clear cell histopathological type form 68.4% of them. The most common presenting symptom was loin pain in 73.7 % of patients followed by, abdominal mass in 47.4 %, while hematuria was seen in 38 % of patients and weight loss was reported by one fourth of patients. The distant metastases were seen in 47.4 % of patients. Regarding laterality, 56.1 % of patients had right kidney tumor and 43.9 % had left kidney tumor. Radical nephrectomy carried out in 53 % of patients, cytoreductive nephrectomy for 12 % of patients and 5 % of patients underwent partial nephrectomy . Conclusion: The incidence of such tumors in Libya has increased, and further cohort studies on risk factors, pathogenesis, and efficacy of minimally invasive surgery vs open surgery are required. Implications of immunochemical stains is critical for suspicious of new metachronous tumors affected by same hormonal receptors. Establishing or introducing screening service in Libya to help in early-stage detection. Importance of target therapy as part of neoadjuvant therapy to prove adequate free resection margin and metastasis cure.