[Clinical study of undifferentiated renal cell carcinoma in comparison with well differentiated cases]

During the past 28 years, 397 patients with renal cell carcinoma were treated at The Jikei University Hospital and its related institutions. Of these, 44 cases with undifferentiated renal cell carcinoma (grade IV) were compared with well differentiated cases (grade I), with regard to following 5 clinicopathological items: 1) general clinical features such as distribution of patient ages, sex ratio, affected side, the relationship of age and the volume of nephrectomized kidney, 2) angiographic appearance, 3) distribution of stages, 4) distribution of metastatic organs, 5) survival rates of each grade and each stage.

1) There was no specific trend in the distribution of affected ages, sex ratio and affected side of the tumour, but the volume of nephrectomized kidney in grade IV cases was much larger than that of the kidneys in grade 1 cases. Furthermore, in grade IV cases, the older the patient, the much lighter was the nephrectomized kidney. 2) No specific trends were observed in the angiographic pattern in the two groups. 3) Regarding stages, 75% of patients with the grade IV had stage IV carcinoma. But, 69% of patients with grade I had stage I. 4) Grade IV patients had a high incidence of lung and liver metastasis compared with grade I, which had a high incidence of bone metastasis. 5) Patients in grade IV and in grade I with stages I-III carcinomas lived longer than any grade with stage IV. So the undifferentiated renal cell carcinoma should be treated with adjuvant therapy even in low stage.