[Clinical study of operative therapy for renal cell carcinoma. 1. Nephrectomy]

A study was made on treatment-related factors, notably prognosis, in 148 patients treated by surgical resection of the primary lesion among 170 consecutive patients who were admitted to the Department of Urology, Gunma University for the treatment of renal cell carcinoma during the period from September 1961 through August 1989. Operative procedures used in this series were radical nephrectomy in 100 patients, simple nephrectomy in 46, partial nephrectomy in 1 and tumor enucleation in 1, lymph node dissection being performed in 53 of the 100 patients treated by radical nephrectomy. The patients receiving surgical resection of the primary lesion were stratified according to sex, PS, disease stage, surgical procedure, lymph node dissection and weight of renal substance resected and comparisons were made on survival rate and recurrence rate among patients in different strata in an effort to observe if these factors are determinant of postoperative prognosis. No significant difference in survival rate was observed between sexes. Patients displaying a PS value of 0 had a significantly higher survival rate than those having a PS value of 1 or above. Whereas a significant difference in survival rare was noted between stage IIIA + IIIB + C disease patients, no significant difference was observed among stage I, II and III patients, thus stages up to IIIA being considered low stage. Radical nephrectomy was associated with a significantly higher survival rate than simple nephrectomy in low stage (stage I-II) disease patients. However, there was no significant difference in survival rate between stage I-II disease patients with vs. without lymph node dissection.(ABSTRACT TRUNCATED AT 250 WORDS)