33 Cases of Advanced Renal Cell Carcinoma, Stage III and IV Follow-up Studies on Management and Survival

Lee, Young Tae; Seel, David John; Lee, Jin Moo

Abstract

Renal Cell Cancer often presents late, the tumor having extended beyond the site of origin. Therapeutic management under such circumstances is not subject to clear guidelines: whether resectional surgery, radiotherapy, chemotherapy, hormone therapy, or even immunotherapy is of value is not clearly established. The authors have collected a series of 33 cases of Stage III and Stage IV renal cell cancer managed over a 20-year period and have analyzed in order to obtain a better understanding of the natural process of this neoplastic disease, is patterns of spread, its sites of metastasis, and the effectiveness of various therapeutic modalities. Their conclusions: 1. Mean survival time was 24.1 months when radical nephrectomy was employed in comparison with 17.1 months when simple nephrectomy was done and 8.6 months when only a biopsy could be performed. 2. The best results were obtained when combined therapy using radical surgery, radiation and chemotherapy was employed. this resulted in a 35.5 months average survival, as compared with 20.5 months when nephrectomy alone was performed. 3. Presence of a solitary metastasis was associated with an average survival of 25.3 months, whereas two metastatic sites lowered survival to 16.1 months and three sites to 10.7 months. 4. The survival time for Stage III disease was 21 months as compared 17.5 months for Stage IV disease.