[Surgical therapy of metastasizing kidney cancer. A retrospective study]

This is a report on the therapeutical results in 38 patients with advanced renal cell carcinoma (Robson stage III and IV). We compared: palliative tumour nephrectomy (n = 10), transfemoral embolisation of the tumour or operative occlusion of the renal vessels (n = 6) and tumours which were primarily or secondarily inoperative (n = 22). In Robson stage II 3 out of 8 patients died after palliative nephrectomy and 6 out of 8 patients died after laparotomy. In Robson stage IV 1 out of 2 patients died after palliative nephrectomy, 5 out of 6 patients died after embolisation and 12 out of 14 patients died before or after laparotomy. The 3 year survival rate for patients with a tumour Robson stage III was 3 out of 8 after palliative nephrectomy whereas none of the patients survived after laparotomy, or without operative treatment. In Robson stage IV none of the patients survived after nephrectomy, only 1 survived after embolisation and 1 patient survived without operative treatment for 3 years. The result of this retrospective study shows that tumour nephrectomy is advisable in Robson stage III with only focalised metastasis of the lymph nodes (N1-2), whereas there are no favourable results in Robson stage IV with an advanced metastasis of the lymph nodes.