Renal Cell Carcinoma: Experiences of 10 Years

Lee, Eun Sik; Park, In Ae; Park, Moon Soo; Ahn, Hen Jong; Lee, Chongwook

Abstract

We reviewed the survival rates and the prognostic factors of 154 patients with renal cell carcinoma managed in Seoul National University Hospital during the recent 10 years. There were 112 men and 42 women. Presentations were hematuria, flank pain, mass and 11 percent of patients showed all. Tumor stages and cellular grades and types were reanalyzed histopathologically in only nephrectomized case. Thirty nine patients were classified in stage I , 17 in stage II, 40 in stage III and 58 in stage IV. One hundred thirty patients were followed from 6 months to 65 months and the mean follow up period was 35.4 months. The 2-year cumulative survival rates of the stage I. R. III and IV patients were 92, 81, 68 and 13 percent, and the 5-year cumulative survival rates were 73, 66. 49 and 0 percent respectively. Of the patients with stage III, 2-year survival rate was 54 percent when both renal vein and capsular invasion were associated. But it was 100 percent when renal vein involvement alone without capsular invasion. The survival rates were decreased markedly by regional lymph node involvement irrespective of capsular invasion. Distant metastases after nephrectomy occurred within 1 year in most of the patients in bone, lung, liver and brain and those were the main causes of the death. The 2-year survival rate of cellular grade I or II patients was 86 percent, whereas 38 percent in grade III. In management of renal cell carcinoma, tumor stage and the cellular grad were most significant prognostic factors. The capsular and lymph node invasions and the distant metastases were also very significant. We suggest the clinical classifications of renal cell carcinoma according to the risk factors: the group 1 includes grade I or III tumors without capsular and lymph node involvement, the group 2 includes grade III tumors with capsular and/or lymph node involvement, the group 3 distant metastasis. Our result indicated that this classification correlates well to the clinical courses of the renal cell carcinoma.