当教室における過去18年間の腎細胞癌の臨床的検討

Abstract

A clinical survey was made on 89 patients with renal cell carcinoma, who visited our department for 18 years from January 1963 to December 1980. These renal cell carcinomas accounted for 87.3% of all renal parenchymal tumors experienced in the same observation period. There were 66 men with an average of 57.1 years old and 23 women with that of 55.3 years old. The most common complaint was macroscopic or microscopic hematuria (73.0%), and this incidence was followed by flank pain, palpable mass, fever, general malaise and weight loss in order. All but 6 underwent nephrectomy, the majority via the transabdominal approach. In 83 patients who received nephrectomy, relative survival rates at 3, 5 and 10 years were 63.8% (standard error 5.7%), 48.6% (standard error 6.0%) and 43.8% (standard error 6.7%), respectively. Pyrexia, an increased erythrocyte sedimentation rate and elevated plasma fibrinogen level were to be considerably predictive factors indicating poor prognosis. Local tumor extension, renal vein tumor involvement, and weight of tumor also appeared able to affect the survival rates. The prognosis of 15 patients with distant metastases was miserable. One of them, however, who had a adrenal metastasis, survived more than 5 years. Patients who underwent nephrectomy followed by the chemotherapeutic regimens; combination of cyclophosphamide and cobalt protoporphyrin, Mitomycin-C and 5-fluorouracil, or carbazilquinone and 5-fluorouracil, did not show any significantly different survival.