Renal Cell Carcinoma: The Ochsner Medical Institution Experience (1945–1978)

Abstract

We reviewed 161 patients operated upon for renal cell carcinoma between 1945 and 1978. Life table and survival analyses were computed to compare the effects of stage, tumor differentiation, cell type, surgical technique, renal vein involvement and sex on the years of survival. Patients with stage I and well differentiated tumors had the best prognosis. All patients surviving 10 years or more had well differentiated tumors. The type of nephrectomy did not affect survival and lymphadenectomy was only of value in staging the disease. The stage and differentiation of the tumor were more important to outcome than choice of therapy.

The Value of Morphological Prognostic Criteria in the Assessment of Renal Cell Carcinoma

“…Due to overlaps of the survival curves, only insufficient prognos tic statements can be made for the range between these two stages. In a retrospective study of Fuselier et al [9], similar overlaps of the survival curves in tumor stages II and III are reported in 161 nephrectomized cancer pa tients.…”

“…The question as to whether or not renal vein involvement is microscopic or macroscopic plays an inferior role according to Fuselier et al [9].…”

Prognostic Parameters in Renal Cell Carcinoma - a New Approach(1)

“…In comparison with earlier studies, our investigations exhibit early Robson stages to a great extent. The survival curves we calculated coincide with the follow-ups described in the literature including the overlapping of the curves for stages 2 and 3 after 5 years' time [9,32]. The overlapping of the curves can be explained by the fact that no great prognostic relevance can be attributed to the factor 'vena cava infiltration' belonging in Robson stage 2 [33][34][35].…”

“…The significance of histological and cytomorphological characteristics in assessing a prognosis has been dis puted in the literature [5,25,32,41,42]. This may arise from the fact that the characteristics applied were not uniformly defined.…”

Metachronous Solitary Contralateral Adrenal Metastasis of Renal Cell Carcinoma

“…3 The prevalence of RCC involvement of the ipsilateral adrenal gland is 19% in autopsy series and 5.5% in surgical series, whereas the contralateral adrenal is involved in up to 11% of autopsy series and 3.4% of surgical series with a variability of latency in diagnosis. 4,5 Although primary RCC metastasis to the adrenal glands is generally hematogenous because of the rich blood supply of the adrenal gland and its high ratio of blood volume to unit weight, 6 and the risk of ipsilateral adrenal metastasis is associated with advanced stage tumors of the upper pole, the predisposing factor for contralateral adrenal metastasis by RCC is still unknown.…”