To assess the radiological and histological features of RCC in patients 18-45 years old that were surgically treated for renal cell carcinoma. To determine the relationship of predefined radiological and histological features to outcomes (survival at 1 year, and documented disease recurrence/progression within 1 year)

Study Design: Retrospective case series Setting: Section of Urology, Aga Khan University Hospital, Pakistan Methods: All patients aged 18–45 years treated surgically for RCC between January 1, 2006, and January 1, 2023, were included. Patients with incomplete records or outside imaging were excluded. Radiological and histological features were correlated with recurrence and one-year survival using Chi-square or Fisher's exact test.

: The study of 132 renal cell carcinoma (RCC) patients revealed that 81% had clear cell grade 2 RCC. Postoperative recurrence occurred in 31.1%, while one-year survival was 87.1%. Most tumors were exophytic (18.9%), with 18.9 % showing vascular involvement. Regarding histological feature 12 % and 23.5 % had positive surgical margin and lymphovascular invasion respectively. Key prognostic factors for disease progression included lymphovascular invasion, positive lymph nodes, T3 disease, grade 2 RCC, and positive surgical margins (p < 0.05). For one-year survival, positive surgical margins and partially exophytic tumors were significant predictors (p < 0.05), highlighting the need for tailored management based on tumor characteristics

The study concludes that specific radiological and histological features significantly impact the prognosis of patients with renal cell carcinoma (RCC) with notable recurrence rate. Overall, the findings underscore the importance of thorough preoperative evaluation and tailored postoperative management based on specific tumor features to improve patient outcomes in RCC.