Clinicopathological Profile and Treatment Outcome of Renal Cell Carcinoma: A Review from a Tertiary Cancer Centre in North East India

Authors

Partha S. Roy Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Hemant Kumar Mittal Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Braja Gopal Behera Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Munlima Hazarika Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Manas Dubey Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Amritjot Randhawa Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Ankur Bhattacharya Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Kakoli Medhi Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Gaurav Das Department of Surgical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Rukmini Bejbaruah Department of Oncopathology, Dr. B. Borooah Cancer Institute, Guwahati, India.

Keywords:

Renal cell carcinoma, clinicopathology, tyrosine kinase inhibitors, survival outcomes, Indian cohort

Abstract

Background and Objectives: Renal cell carcinoma (RCC) constitutes 4% of adult malignancies and 90% of kidney cancers. While extensively studied in Western populations, data from India particularly Northeast India remain limited. This retrospective study aimed to assess overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) among RCC patients treated at a tertiary cancer centre in Northeast India between January 2020 and December 2022.

Materials and Methods: We retrospectively analyzed 88 RCC patients who received treatment. Clinical parameters, including age, sex, histology, stage, metastatic pattern, treatment, and outcomes, were recorded. Kaplan-Meier analysis was used for survival estimation. Prognostic factors were evaluated using univariate and multivariate analyses.

Results: The majority had clear cell histology (85%), with a median age of 56 years and a male-to-female ratio of 3:1. Metastatic disease was present in 65%, commonly affecting the lungs (67%), bones (44%), liver (32%), and brain (10%). Among those with metastasis, 40% were classified as poor-risk according to IMDC criteria. All non-metastatic patients (n=31) underwent surgery (68% radical, 32% partial nephrectomy). Among metastatic patients (n=57), VEGFR tyrosine kinase inhibitors were commonly used sunitinib (n=22) and pazopanib (n=25); one received nivolumab-based immunotherapy. With a median follow-up of 17 months, metastatic RCC showed poor outcomes, with median PFS and OS of 9 and 12 months, respectively. Non-metastatic RCC had an 18-month OS of 80.5%, with median OS not reached. OS varied by IMDC risk: 30 months (favorable), 12 months (intermediate), and 6 months (poor) (p<0.001). Sunitinib and pazopanib had comparable efficacy overall, though sunitinib had superior OS in favorable-risk patients (51 vs. 28 months, p<0.0001).

Conclusions: RCC patients in Northeast India often present younger and with advanced disease. VEGFR-TKIs remain standard in limited access to immunotherapy. Enhanced early detection and access to immunotherapy are vital to improve outcomes.