[Recent management of renal cell carcinoma]

Our experience of radical nephrectomy was analyzed and recent management of renal cell carcinoma was reviewed. One hundred forty-eight patients with renal cell carcinoma were treated by radical nephrectomy between 1970 and December, 1986. The 5-year survival rate according to pathological T-stage was 100% for 4 patients in pT1, 73% for 85 patients in pT2, 51% for 54 patients in pT3, and 0% for 5 patients in pT4. Four patients in pT1 had no venous involvement, lymph node metastasis, or distant metastasis. Thirty patients had venous involvement, 8 in pT2, 20 in pT3 and 2 in pT4. Seventeen patients had positive lymph nodes, 0 in pT2, 15 in pT3 and 2 in pT4. Thirty-three patients had distant metastasis at the time of nephrectomy, 12 in pT2, 18 in pT3 and 3 in pT4. The 5-year survival rates of 30 patients with venous involvement, 17 with lymph node metastasis and 33 with distant metastasis were 47%, 30% and 37%, respectively. No anti-cancer drugs have been recognized to be effective for renal cell carcinoma. However, recent experiences with interferon and lymphokine-activated killer cell therapy suggest that immunotherapy may have a potential role in the management of metastatic renal cell carcinoma.