Epidemiological, Clinical and Prognostic Features of Renal Cancer in a Resource-Limited Setting: A 10-Year Retrospective Cohort Study in Douala, Cameroon

Abstract

Introduction : Kidney cancer is the 14th most frequent cancer and the 3rd urological cancer, with a steadily increasing annual incidence. Despite the accuracy of diagnostic methods and improvements in management strategies, several African studies have shown that diagnosis is often delayed, resulting in a poorer prognosis. In this study, we investigated the epidemiological, clinical, and therapeutic characteristics, as well as factors associated with 5-year survival, in patients with kidney cancer at Douala General Hospital and Laquintinie Hospital in Douala. Methodology : We conducted a retrospective cohort study from January 1, 2014, to December 31, 2023, at the Douala General Hospital and Laquintinie Hospital of Douala. Medical records of patients older than 17 years presenting with a renal tumour suspected of malignancy based on clinical evidence and/or histologically proven were included. Statistical analysis was performed using R software version 4.1.2. Statistical significance was set at p < 0.05. Results : Among 623 urological cancers, 28 patients with renal cancer were analysed (prevalence: 5.1%). The mean age was 49.93 ± 11 years with a male-to-female ratio of 1.8:1. Identified histories included hypertension 25% (7/28), overweight-obesity 50% (14/28), and family predisposition 7.1% (2/28). The presenting mode was the classic triad (flank pain-haematuria-lumbar mass) in 35.7% (10/28); CT urogram was the preferred diagnostic orientation test. Stage III (39.2%) and stage IV (32.1%) were most frequent. The predominant histological type was clear cell carcinoma (42.8%). Extended open radical nephrectomy was performed in 55.5% among operated patients (n = 18). Targeted therapies were administered in 10.7% (3/28) and chemotherapy in 17.8% (5/28). Five-year survival probability was 12.5% with a median survival of 32 months. Right kidney involvement was associated with poor prognosis. Conclusion : Kidney cancer affects both young and elderly patients. Diagnosis is suggested by the triad flank pain-haematuria-lumbar mass, suspicious radiology, and/or histopathology. Management is predominantly surgical. Survival is low and prognosis is generally poor.