Premium
Distinguishing pediatric and adolescent renal cell carcinoma from other renal malignancies
Author(s) -
Syed Jamil S.,
Nguyen Kevin A.,
Wu Charlotte Q.,
Cost Nicholas G.,
Siddiqui Mohummad M.,
Hittelman Adam B.,
Shuch Brian
Publication year - 2017
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26315
Subject(s) - medicine , renal cell carcinoma , nomogram , epidemiology , oncology , odds ratio , concordance , malignancy , surveillance, epidemiology, and end results , population , kidney cancer , incidence (geometry) , not otherwise specified , cancer , cancer registry , physics , environmental health , optics
Purpose Renal cell carcinoma (RCC) represents a small proportion of renal malignancies early in life. Distinguishing RCC from other malignancies is important as treatment strategies may differ. We analyze the Surveillance Epidemiology, and End Results (SEER) database to identify predictive factors of RCC in the pediatric population with renal tumors. Methods We queried SEER to identify patients from ages 0 to 19 diagnosed with a renal malignancy between 1973 and 2013. Cases were sorted using histology and site codes. Age‐adjusted standardized incidence rates (SIR) were calculated. We compared differences in characteristics between cancer types. A logistic regression model and a nomogram were created to identify predictors of RCC. Results A total of 3,670 patients were identified, of which 281 (7.7%) were diagnosed with RCC. The SIR of RCC increased with age. After age 12, RCC was found in >50% of all newly diagnosed cases. On multivariate analysis, RCC was associated with smaller tumor size ( P < 0.001), increasing age ( P < 0.001), black race ( P < 0.001), and localized stage ( P < 0.001). The nomogram predicted RCC pathology with a concordance index of 0.965. Conclusions RCC in childhood and adolescence is relatively uncommon; however, it accounts for >50% of renal malignancies after age 12. For every year of increasing age, the odds of having an RCC diagnosis are increased by 50%. The odds of a renal tumor being RCC are increased in black children, those with localized disease, and those with smaller tumors. In these specific populations, RCC should be favored in the differential diagnosis of the renal mass.