The study aims to describe the timelines from symptom onset to surgery, assess compliance to benchmarks and targets in surgical cancer care and describe short-term outcomes of renal cell carcinoma (RCC) patients who underwent radical or partial nephrectomy in a tertiary university hospital in the Philippines.

A retrospective descriptive study was conducted among RCC patients who underwent radical or partial nephrectomy from January to June 2024 .

28 RCC patients who underwent radical or partial nephrectomy had a mean age of 55.7 years, with a male-to-female ratio of 3.7:1. Most patients were diagnosed at early stages (Stage I and II), which collectively represent about 75% of the cases. This indicates that the majority of cases were detected at localized or early invasive stages. Half of the patients were diagnosed after symptom presentation, while the rest were identified incidentally. The median time interval from symptom onset to first consult and to diagnosis were 3 (IQR= and 11 (IQR) weeks, respectively. The median time from diagnosis to admission for surgery was 16 weeks (IQR =58–393.5 days). One patient (3.6%) was admitted on an emergency basis due to massive hematuria. All patients underwent the necessary baseline clinical work-up and pre-operative staging using CT scan. ECOG performance status was recorded in 89.3%. Only 50% underwent nutritional assessment upon admission, identifying 39.3% as low-risk and 10.7% as high-risk for malnutrition. Only 2 nutritionally at-risk patients received nutritional prescription. Only 28.6% were referred to medical or radiation oncology services preoperatively. None were discussed in a preoperative multidisciplinary conference. Senior urology trainees performed 57.1% of surgeries under supervision and the rest performed by consultants. 14.3% had positive surgical margins. Postoperative complications occurred in 10.4% of cases. Among these, two cases were classified as Clavien-Dindo grade 2, while one was classified as grade 4. No patient died within the 30-day follow-up. The mean (SD) interval between operation and the release of the pathological report was 12.3 (8.4) days. Only 21.4% contained all the required elements of histopathologic report with tumor focality and nodal metastasis as the most commonly omitted findings. Identified barriers included the absence of formal policies mandating explicit lymph node reporting and reliance on traditional practices that implied unifocality when multifocality was not explicitly observed. Although College of American Pathologists(CAP) guidelines were referenced, adherence was inconsistent due to the voluntary nature of CAP template use.

Delays in diagnosis and treatment, gaps in standard preoperative practices, and incomplete pathology reporting reflect areas for institutional improvement. Strategies addressing these issues are critical to enhancing RCC care quality and aligning with global evidence-based standards.