Læknablaðið - 15.12.2008, Blaðsíða 16

FRÆÐIGREINAR
RANNSÓKNIR
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Renal cell carcinoma diagnosed at autopsy in lceland 1971-2005
Introduction: The incidence of renal cell carcinoma (RCC)
is rising in lceland. This has been attributed to increased
diagnostic activity, such as abdominal imaging of unrelated
diseases, rather than changes in the behavior of the
disease. The aim of this study was to compare RCCs
diagnosed in living patients and at autopsy, but also to
investigate the relationship between the incidence of RCC
and autopsy findings.
Material and Methods: RCC found incidentally in
individuals at autopsy was compared to patients
diagnosed alive over three decades in lceland (1971-2005).
Stage at diagnosis and tumor histology was reviewed.
Results: 110 tumors were diagnosed at autopsy with a
rate of 7.1/1000 autopsies. When compared to patients
diagnosed alive (n = 913) the mean age at diagnosis
was higher in the autopsy group (74.4 vs. 65 yrs.) while
male to female ratio and laterality was similar. Tumors
found at autopsy were smaller (3.7 vs. 7.3 cm), at lower
stage (88% at stage l+ll vs. 42%) and at lower tumor
grade (85% at grade l+ll vs. 56%). A difference, although
smaller, is present when the autopsy detected cases are
compared to only incidentally detected RCCs in living
patients. Furthermore the autopsy detected tumors were
more frequently of papillary cell type (21 % vs. 8%). After
correcting for declining autospy rate (>50%), a slight
trend for a reduced rate of autopsy dectected RCC cases
was seen during the last 10 years of the period but the
difference was not significant.
Conclusion: RCCs diagnosed at autopsy are at a lower
stage and tumor grade than in patients diagnosed alive.
The autopsy-rate is declining in lceland with fewer RCCs
found per autopsy. After correcting for the decline in
autopsy rate, the rate of RCC detected at autopsy is
relatively unchanged. The increase in incidence of RCC is
Key words: Renal cell carclnoma, autopsy dlagnosis, autopsy rate, incidential diagnosis, incidence, histopathology.
Jonsson A, Hardarson S, Petursdottir V, Palsdottir HB, Jonsson E, Einarsson GV, Gudbjartsson T. Renal cell carcinoma
diagnosed at autopsy in lceland 1971-2005. Icel Med J 2008; 94: 807-12.
Correspondence: Tómas Guöbjartsson, tomasgud@iandspitaii.is
Barst: 1. ágúst 2008, - samþykkt til birtingar: 3. nóvember 2008.
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