腎細胞癌の臨床的研究

Abstract

A statistic survey was made on twenty cases of renal cell carcinoma experienced at Department of Urology of Aichi Medical University Hospital and Tosei Municipal Hospital during the period from january 1973 to November1979. 1. Renal cell carcinoma was found in 0.18% of all the new patients who visited the urologic clinics during the period above. 2. The fifth decade was most frequently involved. The average age was 59.6. Involved side showed no difference. The male to female ratio was 3: 1. 3. As to triad of renal carcinoma, gross hematuria was seen in 80%, mass in the renal res ion 20% and pain in the same region 25%. As to extraurinary symptoms, fever was noted in 10%, general malaise 25%, weight loss 15%, loss of appetite 10%, headache 10%, and symptoms due to metastasis 15%. 4. Pathologically, 45% weighed more than 500 grams, 40% showed renal vein invasion, 65% showed low stage and 35% high stage. As to cell types, 45% was clear cell and 55% mixed cell type. 5. Laboratory examinations revealed pyrexia in 50%, accelerated ESR in 65%, anemia in 10%, showed low stage and 35% high stage. As to cell types, 45% was clear cell and 55% mixed cell type. 5. Laboratory examinations revealed pyrexia in 50%, accelerated ESR in 65%, anemia in 10%, erythrocytosis 10%, leukopenia 5%, positive serum CRP in 85%, high serum alkaline phosphatase in 25%, high serum LDH 40% and high alpha-2-g10bulin in 55%. 6. Nephrectomy was done in all cases. Then, chemotherapy, radiation therapy and/or hormone treatment was combined in most of them. The combination was as follows: No adjuvant treatment 10% Plus chemotherapy 5% Plus hormone treatment 5% Plus chemotherapy and hormone 65% Plus chemotherapy and radiation 5% Plus chemotherapy, hormone and radiation 10% 7. A survival study showed 45% of death which occurred all within one year postoperatively. Poor prognosis must be considered in cases of heavy tumor more than 500 grams, renal vein invasion, high stage, mixed cell type, accelerated ESR, positive CRP and elevated alpha-2-globulin.