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Risk of bilateral renal cell cancer
Journal of Clinical Oncology, 08/10/09

Wiklund F et al. – Study reports that the risk of metachronous bilateral renal cell cancer is drastically higher among patients first affected at a young age, suggesting a subset of early onset renal cell cancer with a strong genetic component.

Methods

Aim was to investigate the risk of developing bilateral kidney cancer in a large population-based study with long-term f/u
28,642 pts were followed for an average of 4.4 yrs
Standardized incidence ratio, defined as the ratio of observed number of bilateral cancers to the number expected on the basis of the incidence was used as a measure of relative risk
Multivariate Poisson regression was used to separate the effects of the explanatory variables

Results

A synchronous bilateral renal cell cancer was reported in 86 pts
A total of 112 metachronous bilateral cancers were recorded during 126,493 person-yrs of f/u vs 35.8 expected
This yielded an overall relative risk (RR) of 3.1 and a cumulative incidence of 0.8% after ≥20 yrs of f/u
Multivariate analyses: risk increased monotonically with younger age at first diagnosis
Compared with pts who were ≥60 yrs, those <40 yrs were at a 17-fold higher risk
A modest but statistically significant decreasing trend with increasing duration of f/u was also found

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