過去5年間における腎腫瘍の臨床統計的観察

Abstract

A clinical observation was done on 44 cases o f benigne and malignant renal tumors treated in our department for the past 5 years. The results are as follows : 1) Incidence. The cases o f renal tumor occupied 2.3% of total number of admission during the period. 2) Initi a l symptoms. The commonest symptom was hematuria, especially in cancer of the renal pelvis. One fourth of the patients with renal tumor complained of some equivocal symptoms at onset of the disease. The period in average from onset of the symptoms to admission was 24 months in renal parenchymal tumor and 14 months in cancer of the renal pelvis. 3) Symptoms at admission. Hematuria, palpable tumor and pain in the renal region were commonest symptoms. Percentages of hematuria, palpable tumor and the pain were 82%, 29% and 39% respectively in renal parenchymal tumor, and were 100%, 73% and 55% respectively in cancer of the renal pelvis. 4) Radiographic findings. Intrav e nous pyelography, retrograde pyelography and aortography were useful in making diagnosis of renal tumor, while retroperitoneal pneumography was useful in visualizing outline of tumor and in showing degree of adhesion. In renal parenchymal tumors, elongation and compression of calyx (68%), elongation and compression of the pelvis (46%) and non-visualization of the involved kidney in intravenous pyelography (32%) were common radiographic signs. In cancer of the renal pelvis, pelvic dilatation (64%), filling defect of the pelvis and calyx (55%) and obliteration of the caly x (45%) were common. 5) Treatment. Twenty-four cases of parenchymal tumor were laparotomized and the involved kidney was removed in 22 of them. Ten cases of pelvic cancer were operated on and the involved kidney was removed in 9 of them. Conservative treatment, such as x-ray and radioactive cobalt irradiation and anticancer chemotherapy, was carried out in many cases without noticeable improvement except for Wilms' tumor. 6) Weight of specimens. The specimens of parenchymal tumor were found to be heavier than those of pelvic cancer. 7) Prognosis. Three-year survival rate in parenchymal tumor was 0%, while that of pelvic cancer was 36%. From this result better prognosis could be expected in cancer of the renal pelvis than in parenchymal tumor.