Outcome of surgery in cystic renal cell carcinoma

Objectives. To review cases of cystic renal cell carcinoma treated surgical ly at our institution and define their clinical and histopathologic feature s. Methods, Between 1986 and 1998, 21 patients with cystic renal cell carcinom a were treated surgically. Cystic renal cell carcinoma was categorized usin g Hartman's classification. Results. Histopathologic examination demonstrated cystic necrosis in 11 pat ients, multilocular cystic renal cell carcinoma in 9, and unilocular cystic renal cell carcinoma in 1 patient. Tumors were incidentally found during a n evaluation of unrelated disease or a general health checkup in 14 patient s (67%). The mean tumor size was 5.6 cm (range 0.5 to 12)for cystic necrosi s and 5.4 cm (range 2 to 9) for multilocular cystic renal cell carcinoma. A ll 9 cases of multilocular cystic renal cell carcinoma were of the clear ce ll type and tumor grade 1. The mean follow-up period was 65 months (range 9 to 141). The 5-year disease-specific survival rates for multilocular cysti c renal cell carcinoma and cystic necrosis were 100% and 80%, respectively. Conclusions. The prognosis for patients with cystic renal cell carcinoma is better than that for patients with solid tumors. In particular, the progno sis of multilocular cystic renal cell carcinoma is excellent. Multilocular cystic renal cell carcinoma represents a distinct subtype of renal cell car cinoma that can be completely cured by surgery. UROLOGY 56: 67-70, 2000. (C ) 2000, Elsevier Science Inc.