Henriksson C, Geterud K, Aldenborg F, Zachrisson B F, Pettersson S
Department of Surgery, Sahlgrenska Hospital, Göteborg, Sweden.
Eur Urol. 1992;22(3):209-12.
Computed tomography (CT) was carried out in 31 patients 10-43 years after surgery for renal cell carcinoma, 10 belonging to a consecutive series of patients operated upon at one urological department 10 years previously. Twenty-eight patients were symptomless, and 3 had flank pain, severe fatigue and hematuria, respectively. Cancers in the remaining kidney were found 13-21 years after nephrectomy in 4 of 31 patients (12.9%). The 3 patients with symptoms were among these 4. An adenoma was found in 1 patient 10 years after nephrectomy. The cancers were treated by renal resection in 2 patients, multiple tumors made nephrectomy necessary in 1 patient and 1 patient was not operated upon because of disseminated disease. The adenoma indicated future checkup by CT. Three of the 4 new cancers had a dismal outcome. The renal parenchyma was found to be essentially normal in all the other 26 patients, irrespective of the widely varying time interval between nephrectomy and CT. Asynchronous bilateral renal cell carcinoma has a poor outcome which presumably can be improved by early diagnosis and aggressive treatment. CT is the method of choice for early detection and follow-up of renal tumors. It should be carried out every other year after nephrectomy for renal cell carcinoma.
对31例肾细胞癌术后10 - 43年的患者进行了计算机断层扫描（CT），其中10例来自10年前在一个泌尿外科连续接受手术的患者系列。28例患者无症状，3例分别有胁腹痛、严重疲劳和血尿症状。31例患者中有4例（12.9%）在肾切除术后13 - 21年发现对侧肾脏出现肿瘤，有症状的3例患者就在这4例之中。1例患者在肾切除术后10年发现腺瘤。2例癌症患者接受了肾切除术，1例因多发肿瘤而行肾切除术，1例因疾病播散未接受手术。该腺瘤提示需进行CT随访检查。4例新发癌症中有3例预后不良。在所有其他26例患者中，无论肾切除与CT检查之间的时间间隔差异多大，肾实质基本正常。异时性双侧肾细胞癌预后不良，早期诊断和积极治疗可能改善预后。CT是早期发现和随访肾肿瘤的首选方法。肾细胞癌肾切除术后应每隔一年进行一次CT检查。
