転移のある腎細胞癌患者における腎摘除術の適否

Abstract

Indications for nephrectomy in patients with renal carcinoma with metastasis are controversial and remain poorly defined. In an effort to define the role of nephrectomy more clearly, we have reviewed our experience with 62 patients. Of these patients of renal cell carcinoma with distant metastasis at the time of diagnosis, 32 underwent nephrectomy as a part of the over-all treatments, while the primary renal lesion was not removed in 30. One year survival rate of the patients undergoing nephrectomy was 37.5% (12 of32), compared to 32.1%(9 of 30) for the patients without nephrectomy. This difference is not statistically significant by chi square analysis. However, 4- of the patients undergoing nephrectomy lived more than 3 years, while all the patients without nephrectomy died within 25 months. Nephrectomy did not alter the survival rate of either group, but significant prolongation of survival was seen only in some patients undergoing nephrectomy which might perform cyto-reductive surgery. Therefore, we advocate that nephrectomy should be done in patients with metastatic renal carcinoma.