腎癌の臨床 --臨床症状,臨床検査成績と予後との関係,および転移を有する症例について--

Abstract

One hundred and twenty-three cases of renal cell carcinoma, treated at Department of Urology, Kyoto University Hospital during January 1955 through December 1977 were reviewed. 1. As the patients were classified according to Holland's classification, twelve cases were stage I, nineteen cases stage II, fifty-three cases stage III, twenty-two cases stage IV, and seventeen cases unclassified. 2. Overall relative survival rate at one year, three year, five year, ten year were 72%, 50%, 46%, 34% respectively. 3. The most common symptom was macroscopic hematuria, and followed by pain, fever, weight loss, fatigue and plapable mass. 4. Relative survival rate of the patients who showed macroscopic hematuria was better than that of the patients who did not show macroscopic hematuria. Relative survival rate of the patients who did not have palpable abdominal mass was better than that of the patients who had palpable abdominal mass. The presence of pain or fever did not alter the survival rate. 5. As for the laboratory findings, elevation of erythrocyte sedimentation rate was most common, followed by positive C-reactive protein, elevation of alkaline phosphatase value, elevation of lactic dehydrogenase value, and serum Ca elevation. 6. The relative survival rate of the patients who showed normal erythrocyte sedimentation rate or alkaline phosphatase value were better than the patients who showed abnoraml erythrocyte sedimentation rate or alkaline phosphatase value. The higher the erythrocyte sedimentation rate showed, the poorer the relative survival rate of the patient. 7. The site of distant metastasis was most common in lung, followed by bone, lymph node and liver. The patients with bone metastasis lived longer than the patients with lung metastasis. 8. No remarkable difference was seen between the survival rate of the patients treated by nephrectomy alone and nephrectomy plus adjuvant therapy.