Renal cell carcinoma (RCC) associated with primary tumors involving different steroid hormone target tissues: Relationship with reproductive and hormone factors

Objective Aim of this study was to analyse the characteristics of seventeen female, patient with RCC associated with other primary neoplasms occuring in steroid hormone target tissues. The reproductive history of these patients and the use of exogenous hormones were taken into consideration. Materials and Methods In this study we evaluated seventeen female patients, 33 to 68 vears old (mean age 54.4 years) who presented a history of multiple primary tumors in which a RCC was associated with tumors in the breast, uterus or overy. Preoperative staging investigations, pathological findings, hormone and surgical treatment for each primary tumor are reported.The presentation of a second priman tumor was descrihed as synchronous or metachronous evaluating the time interval between the discover, of the two neoplasms. All patients were submitted to radical nephrectomy. regional lymphadenectomy was routinely performed and none of the patients received adjuvant therapy. The postoperative follow-up after radical nephrectomy ranged from 9 to 66 months (mean 32.7 months). Survival rates in the 17 female cases were evaluated after surgical removal of both primary tumors. The reproductive history of these patients and the use or exogenous hormones have also been studied Moreover, in 7 out of the P females ,plasma 17 beta estradiol and estrone levels were determined by radioimmunoassay (RIA) upon diagnosis of each of the primary tumors Results In these 17 RCC, the over-all disease specific survival rate was 58.8%; seven patients died from metastatic disease with a mean survival of 14.7 months. As far as concerns pathologic stage of RCC, a significant difference in mean survival was found between pN0 (mean survival 22.1 +/- 3.4 months}and pN1 RCC (mean survival 13.7 +/- 3.5 months) Mean age at menarche in the 17 female cases was 12.8 +/-1.0 years two cases (11.8%) were nulliparous, 6 (35.3%) women had given birth to 1 child. 5 (29.4%) had had 2 births and 4 (23.5%) had had 3 births Thirteen cases (76.4%) were post-menopausal at the diagnosis of the rtrsi primary tumor. Mean age at menopause in the post-menopausal women was 51.7 +/- 1.2 years. Never use of oral contraceptives (OC) was reported by 12 (70.5%) of the women. Plasma 17 beta estradiol and estrone levels were determined m only 7 patients at diagnosis of each of the primary tumors.High plasma estrogen levels were found in 4 cases with RCC + breast carcinoma and in I case with RCC + endometrial carcinoma :in the remaining 2 cases. low normal values were found. Conclusions A relationship appears to exist between certain reproductive and hormone related factors and the risk to develop these tumor associations. Data emerging from the present study support a involving steroid hormone target tissues.