Renal cell carcinoma: earlier discovery and increased detection.

To document the earlier discovery and increased detection of renal cell carcinoma, the authors reviewed cases of renal cell carcinoma detected at their institution during 1974-1977 and 1982-1985, with particular emphasis on renal tumors 3.0 cm or smaller. Only 5.3% (four of 75) of renal cell carcinomas found during 1974-1977 but 25.4% (31 of 122) found during 1982-1985 were 3.0 cm or smaller, an increase of almost five times. Of the small tumors in the 1982-1985 group 96.7% (30 of 31) were incidentally discovered, and 77.4% (24 of 31) were initially detected with computed tomography (CT) or ultrasound (US). In the later series 48.4% (15 of 31) of the small renal tumors were treated with partial nephrectomy. Follow-up shows no recurrences. Many more small renal tumors are being detected because of the use of CT and US. This will undoubtedly increase the cure rate of renal cell carcinoma because these tumors are being detected when they are small and do not cause symptoms. Partial nephrectomy will increasingly be used in the management of these small tumors.