[Renal carcinoma. Our experience of 20 years]

Review of 174 renal parenchyma adenocarcinoma surgically removed over a period of 20 years with follow-up ranging from 1 to 20 years. Age, sex, time from onset of symptoms and treatment, tumour size and cell type did not influence survival. This was improved the lower the stage was at surgery (80% at 5 years in I, 56% in II, 55.5% in III-A, 11% in III-B+C, 0% in IV). The lack of differences in survival between stages II and III-A is conditioned by the fact that III-A included cases with and without perirenal fat involvement but with a common factor of renal vein involvement. Such factor modifies survival with equal local size (80% at 5 years for T1-2 VO and 83% for T1-2 V1; 56% for T3 VO and 44% for T3 V1. Survival for G1+2 was 66% at 5 years, versus 33% for G3+4. Initial therapy was radical nephrectomy with hilar lymphadenectomy, and there was no difference in survival with regard to the access route used.