In this study, we examined some of the morphological values from the large number of prognostic parameters indicated in the literature by establishing survival statistics. Primary distant metastasis formation was confirmed to be a prognostically unfavorable factor. Regional metastasis formation takes an intermediate position between the primarily distantly metastasized and the primary non-metastasized renal cell carcinoma. In the primarily non-metastasized renal cell carcinoma, tumor invasion into the renal vein is associated with prognostic deterioration, obviously due to a linkage to other unfavorable tumor characteristics. The histological degree of malignancy as a single prognostic parameter seems to be of little informational value if no other tumor data are taken into consideration. The classification of renal tumors according to Robson proves to be of great clinical relevance, especially when it is combined with the histological degree of malignancy. The prognostic scheme by Hermanek ‘combined staging and grading’ must be recommended as the prognostic scheme of choice. Apart from special histological types of the renal cell carcinoma, such as the papillary or sarcomatous variant, and with reservation as to the tendency to unpredictable secondary metastasis formation that is peculiar to the renal cell carcinoma, a prediction of the prognosis according to the morphological criteria mentioned above is possible to a satisfactory degree within certain limits.
40% or 116 of 350 patients with renal carcinoma had distant metastases at the time of hospital admissio (M1, N0-4). Women fell ill less often than men did (3:7). 82 of 116 patients (71 %) received nephrectomy primarily Lethality within the first 30 days was 6%. Patients with nephrectomy survived longer than those without, women witl nephrectomy survived longer than men. Patients with a grade II tumor survived longer than those with a grade III tumor. Palliative nephrectomy can therefore be recommended as treatment of choice, if the general condition of the patient allows it, the more so as there are no alternative ways of treatment.
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