Long-term outcomes and survival rates of renal cell carcinoma patients in Erbil, Iraq: a follow-up study

Background Renal cell carcinoma (RCC) is a heterogeneous group of cancers originating from renal tubular and epithelial cells, constituting 2-4% of global cancer cases. Incidence patterns vary internationally, with the Czech Republic and European Baltic countries experiencing higher rates. Despite the majority of cases being sporadic, approximately 4% have a hereditary basis. Methods This study, conducted in Erbil, Iraq, investigates RCC survival rates and influential factors at Nanakaly Hospital and Rizgary Oncology Center. A retrospective analysis spanning January 2017 to December 2020, covering 93 patients, explores demographic, clinical, and treatment variables. Results Out of a total of 93 cases, there were 68 deaths, and 25 cases were censored. This means that 73.12% of the cases resulted in death, and 26.88% of the cases were censored. The Kaplan-Meier survival analysis indicates a mean survival time of approximately 5.517 years. Clinical characteristics such as tumor side and histology show no significant associations with survival status, except for the TNM stage (p-value < 0.001). While smoking, alcohol history, history of malignancy, and comorbidities demonstrate no significant impact on survival, the study identifies a potential trend associating comorbidities with poorer outcomes (p-value = 0.051). Significant associations emerge with treatment types; radical nephrectomy (p-value = 0.004) and systemic treatments (p-value < 0.001) influence survival. Strikingly, recurrence was significantly associated with mortality (p-value < 0.001). Conclusions The study reveals a higher RCC had a shorter survival in Erbil compared to international survival. This is attributed to delayed referrals and advanced disease stages. Additionally, the absence of crucial antineoplastic agents negatively affects outcomes. Comorbidities are also found to significantly reduce survival rates. These findings underscore the necessity for an enhanced referral system, improved access to oncological services, and the approval of essential therapies in Erbil.