[Renal cell carcinoma].

Abstract

Forty-two cases of renal cell carcinoma with pulmonary metastasis were clinically investigated with regard to their pathological state and treatment methods. Of these 42 cases, pulmonary metastasis was noted initially in 18 cases, and in the remaining 24 cases it occurred after nephrectomy. In 20 cases (83%) pulmonary metastasis was detected within 2 years for the treatment of primary lesion. For the treatment of pulmonary metastasis, surgery was performed in 2 cases, radiotherapy in 4 cases, chemotherapy in 21 cases and hormonal therapy in 13 cases. One of the 2 patients who received surgery has survived for 7 years and 11 months, and the other for 6 months, respectively. Among the 4 cases treated by radiotherapy, a complete remission was noted in 1 case, and no improvement in 3 cases. Twenty-one cases were treated with chemotherapeutic agents. Out of these 21 cases, an objective improvement was observed in 3 cases (14%): 1 case received 3 drug combination (mitomycin C, 5-fluorouracil and cytosine arabinoside) and 2 cases received 5-fluorouracil dry syrup. Hormonal agents used were progesterone in 9 cases and testosterone in 4 cases. In the hormonal therapy group, no remission of metastatic lesions was confirmed by chest X-ray examination in 14 cases. The 1-year and 3-year survival rates were 32% and 16%, respectively. However, 4 out of 42 patients have been alive for over 5 years after the treatment for pulmonary metastasis. Therefore, even in the occurrence of pulmonary metastasis aggressive treatment including chemotherapy is preferable.