There have been conflicting reports in the literature regarding the association of other malignancies with renal cell carcinoma (RCC).

In this study by Beisland and colleagues, out of Norway, the association of RCC with other malignancies is again examined.

In this retrospective analysis, 1425 patients with RCC presented over a 6 year period and were evaluated for the presence of an antecedent, synchronous, or subsequent other malignancy. There were 909 men and 516 women.Mean patient age was 59.1 and the median time of observation after the diagnosis of RCC was 12 years. Of these 1425 patients, 257 were found to have another malignancy. In descending order, the most common other malignancies were prostate, bladder, lung, breast, and colon. In this study, 34.8% of the other malignancies were antecedent, 18.7% were synchronous, and 46.7% were subsequent to the diagnosis of RCC. The observed subsequent development of a second malignancy was significantly higher (22%) than was expected based on population incidences, especially for the development of bladder cancer, non-Hodgkin’s lymphoma, and melanoma. The 15 year cumulative risk for the development of a secondary malignancy was 26.6% for men and 15.5% for women (p=0.04). Interestingly, in this study, patients that presented with an antecedent or synchronous other malignancy demonstrated a significantly worse survival.

This study, like others in the literature, suggests that there is an epidemiologic link between RCC and other malignant tumors. In particular, the increased risk (26.6% for men at 15 years) of developing a subsequent malignancy suggests that long term follow-up and general cancer surveillance screening is appropriate in this patient population.

By Christopher G. Wood, MD