Follow-Up and Prognosis of Renal Carcinoma in a Series Operated by Perifascial Nephrectomy Combined with Adrenalectomy and Retroperitoneal Lymphadenectomy

Abstract

A previous study of a series of 58 extensively operated patients with renal carcinoma showed that metastasis is influenced by tumor size and cell type independently of each other. The result of a follow-up of this series is presented here. The crude survival rate was 69% and the corrected 5-year survival rate for the 45 patients without distant métastasés at the operation was 80% for group II tumours and 60% for group III tumors). Tumor cell type was found to be of prognostic significance but tumor size only in tumors containing the most malignant cell type. Invasion of the pelvic wall, tumor thrombus of the main stem of the renal vein and tumor spread inside the renal fascia were not found to influence the prognosis in patients without distant métastasés. A different malignant tumor was found in 19% and an uroepithelial tumor in 7% of 58 patients before or during the follow-up period (5 — 10 years). Local tumor growth was seen in 5 of the 29 patients who died during the observation period (5-10 years) and were autopsied. 3 out of 5 had shown distant métastasés at the operation. The study strongly supports the opinion that patients without distant métastasés should be operated upon with an extensive nephrectomy.