Abstract
The objective of this study was to evaluate the prognostic factors and role of nephrectomy in metastatic renal cell carcinoma. We reviewed 62 cases of metastatic renal cell carcinoma (RCC) at presentation to document the factors influencing the survival and to evaluate the role of nephrectomy. Sex and age of the patients, size of the primary tumour, site and number of the metastases, nephrectomy, cell type and grade of the tumour and type of the medical treatment were analyzed as prognostic factors. The age and sex of the patients, cell type and type of the medical treatment did not appear to be significant predictors of prognosis. However, improved survival was correlated with tumours ≤7 cm in diameter, low grade tumours, metastasis limited to single organ and removal of the primary tumour. When these parameters were analyzed in a combined manner patients who had undergone nephrectomy showed consistently longer survival. We suggest that nephrectomy should be considered in all patients with metastatic RCC, as long as the morbidity of the operation is predicted to be acceptable.
Similar content being viewed by others
References
Patel, N. P., Lavengood, R. W.: Renal cell carcinoma: Natural history and results of treatment.J. Urol., 119, 722 (1978).
deKernion, J. B., Lindner, A.: Treatment of advanced renal cell carcinoma.Prog. Clin. Biol. Res., 100, 641 (1982).
Figlin, R. A., Abi-Aad, A. S., Belldegrun, A., deKernion, J. B.: The role of interferon and interleukin-2 in the immunotherapeutic approach to renal cell carcinoma.Sem. Oncol., 18 (Suppl.), 102 (1991).
Burke, H. B., Henson, D. E.: Criteria for prognostic factors and for an enhanced prognostic system.Cancer, 72, 3131 (1993).
Robson, C. J., Churchill, B. M., Anderson, W.: The results of radical nephrectomy for renal cell carcinoma.J. Urol., 101, 297 (1969).
Cox, D. R.: Regression models and life tables.J. R. Stat. Soc. B., 34, 187 (1977).
Golimbu, M., Joshi, P., Sperber, A., Tessler, A., Al-Askari, S., Morales, P.: Renal cell carcinoma: Survival and prognostic factors.Urology, 27, 291 (1986).
Maldazys, J. D., deKernion, J. B.: Prognostic factors in metastatic renal cell carcinoma.J. Urol., 136, 376 (1986).
Dal Bianco, M., Artibani, W., Bassi, P. F., Pescatori, W., Pagano, F.: Prognostic factors in renal cell carcinoma.Eur. Urol., 15, 73 (1988).
Naito, S., Kimiya, K., Sakamoto, N., Soejima, T., Ueda, T., Kumazawa, J., Osada, Y., Sagiyama, K., Ariyoshi, A.: Prognostic factors and value of adjunctive nephrectomy in patients with stage IV renal cell carcinoma.Urology, 37, 95 (1991).
Rackley, R., Novick, A., Klein, E., Bukowski, R., McLain, D., Goldfarb, D.: The impact of adjuvant nephrectomy on multimodality treatment of metastatic renal cell carcinoma.J. Urol., 152, 1399 (1994).
Bennett, R. T., Lerner, S. E., Taub, H. C., Dutcher, J. P., Fleischmann, J.: Cytoreductive surgery for stage IV renal cell carcinoma.J. Urol., 154, 32 (1995).
Mani, S., Todd, M. B., Katz, K., Poo, W. J.: Prognostic factors for survival in patients with metastatic renal cancer treated with biological response modifiers.J. Urol., 154, 35 (1995).
Montie, J. E., Stewart, B. H., Straffon, R. A., Banowsky, L. H. W., Hewitt, C. B., Montague, D. K.: The role of adjunctive nephrectomy in patients with metastatic renal cell carcinoma.J. Urol., 117, 272 (1977).
Medeiros, L. J., Gelb, A. B., Weiss, L. M.: Renal cell carcinoma: Prognostic significance of morphologic parameters in 121 cases.Cancer, 61, 1639 (1988).
Fairlamb, D. J.: Spontaneous regression of metastases of renal cancer: A case report and of two cases including the first reported regression following irradiation of dominant and review of the world literature.Cancer, 47, 2102 (1981).
Montie, J. E.: Editorial: Prognostic factors for renal cell carcinoma.J. Urol., 152, 1397 (1994).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Uygur, M.C., Usubütün, A. & Özen, H. Prognostic factors and the role of neprectomy in metastatic renal cell carcinoma. International Urology and Nephrology 30, 681–687 (1998). https://doi.org/10.1007/BF02564853
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02564853