Renal Cell Carcinoma: Natural History and Results of Treatment

Abstract

Cases (166) of renal cell carcinoma were reviewed. The presenting symptoms varied from vague backache to hypovolemic shock. The most common symptoms were pain, hematuria, a palpable mass and hypertension. Most cases involved were clear cell carcinoma (83%), and survival was no better than in cases of granular cell carcinoma. The tumors metastasized to almost every organ of the body. Bilateral simultaneous primary renal cell carcinoma was described in 1 patient, who survived for more than 5 yr. The overall 5 yr survival rates of simple and radical nephrectomy were 32 and 66.6%, respectively. Radiation therapy does not improve survival irrespective of stage. The 5 yr survival rate with renal vein involvement was 32%. Nephrectomy in patients with distant metastases did not alter survival. Among patients with metastases 74% were dead before 1 yr and 96% before 3 yr.