腎細胞癌の臨床的研究

Abstract

過去13年間に腎細胞癌と診断した82例について臨床統計的観察を行った.1)男女比は1.6:1で男子に多く, 年齢は50歳代がもっとも多く, 平均年齢は58.8歳であり, 患側左右比は差を認めなかった.2)初発症状としては, 肉眼的血尿が82例中37例(45%)ともっとも多く認められたが, 無症状の症例が11例(13.4%)に認められた.転移部の症状を初発症状としたものは5例(6%)であった.3)浸潤度別ではstage 1が82例中38例(46%), stage 4が30例(37.6%)と大半を占めていた.4)初診時, 転移部位としては肺が18例ともっとも多く, ついで骨10例, 肝9例の順であった.5)予後についてみると全体の1年, 3年, 5年実測生存率はそれぞれ77%, 58%, 48%であった.stage 4における腎摘群および非腎摘群の比較では有意差を認めなかったが, 非腎摘群に対する動脈塞栓術の有無による比較検討では, 動脈塞栓術併用群に予後の延長が認められた

Eighty two cases of renal cell carcinoma, treated at our Department between July, 1971 and May, 1984, are reviewed. The highest incidence of this disease was seen in the 5th decade and the average age of the patients was 58.8 years. Male patients predominated over the female patients, the ratio being 1.6: 1. According to Robson's classification, thirty eight cases were in stage I, five cases in stage II, nine cases in stage III and thirty cases in stage IV. The overall survival rate at one, three and five years was 77, 58 and 48%, respectively. The most common symptom was macroscopic hematuria, followed by asymptomatic, lumbago and palpable mass. The site of distant metastases was most frequently in the lung, followed by the bone, liver and lymph node. There were no remarkable differences in the prognosis of stage I patients, between the group treated with preoperative renal arterial embolization and non-treated group. No remarkable difference was seen between the survival rate of the stage IV patients treated by nephrectomy and these not treated by nephrectomy. Renal arterial embolization was an effective therapeutic measure for patients with non-resectable stage IV renal cell carcinoma (p = 0.0647, compared with non-treated group).