腎細胞癌の臨床的研究(臨床成績と予後)

Abstract

過去21年間TEKKグループにおいて腎摘出術がおこなわれ組織学的に確認された132例の腎細胞癌について臨床的検討をおこなった.1)男女比は2.07:1, 発症年齢は50歳～70歳が61.4%を占めており, 平均年齢は57.3歳であった.患側は左側73例, 右側59例と, 左側が多かった.2)症状は血尿55.4%・腹部腫瘤19.2%・腰腹部痛13.8%・発熱6.9%が主なものであった.3)遠隔転移は19.7%にみられ, 肺(54%)・骨(19%)が多かった.4) 132例全体の予後は1年・3年・5年相対(実測)生存率は84.3% (83%)・61.3% (58.2%)・63.3% (56.9%)であった.5)臨床的に予後を悪くする因子としては, 左側・50歳以上・赤沈の亢進・CRP陽性・α2-globulinの高値・遠隔転移が考えられた

One hundred and thirty-two patients with renal cell carcinoma, treated by the TEKK Group, during the period from 1962 to 1983 were clinically reviewed. The patients ranged in age from 13 to 77 years with a mean age of 57.3 years, and were 89 men and 44 women, with a sex ratio of 2.07 to 1. The most common symptom was hematuria (55.4%), followed by palpable mass (19.2%), pain (13.8%) and fever (6.9%). The distant metastasis was observed in 26 patients (19.7%), mostly in the lung (54%) and the bone (19%). Overall estimated survival rates at 1, 3 and 5 year were 83.0%, 58.2% and 56.9% respectively. The prognosis of the patients with renal cell carcinoma was dependent upon affected site, age, ESR, CRP, alpha 2-globulin and distant metastasis.