Igarashi T, Murakami S, Hara S, Tanaka M, Oki T, Isaka S, Okano T, Abe K, Shimazaki J, Matsuzaki O
Department of Urology, Asahi General Hospital.
Hinyokika Kiyo. 1991 Sep;37(9):975-80.
Between January, 1975 and December, 1989, 86 patients with renal cell carcinoma received radical nephrectomy associated with lymphadenectomy at our institutions. Pathological examination revealed lymph node metastasis in 15 patients (17.4%). The incidence of lymph node metastasis increased in accordance with the aggravation of tumor stage (p less than 0.01) and grade (p less than 0.05). Patients with a rapidly growing tumor showed higher incidence of lymph node metastasis than patients with a slow growing tumor (p less than 0.01). Regional lymph node metastases were found in 3 of the 41 patients with a slow growing tumor. Since these 3 patients are surviving with no evidence of disease for 38.7 months on average, the regional lymphadenectomy was considered to have been effective for their survival. Nine of the 25 patients with a rapid growing tumor had progressive lymph node metastasis. Four of them had apparent tumor thrombi as well as lymph node metastasis, and 2 of them had distant metastasis. These patients showed poor prognosis even after operation. Lymphadenectomy was of no value to the patients with apparent tumor thrombi and/or distant metastasis.
1975年1月至1989年12月期间，我院86例肾细胞癌患者接受了根治性肾切除术及淋巴结清扫术。病理检查发现15例患者（17.4%）有淋巴结转移。淋巴结转移的发生率随肿瘤分期的加重（p<0.01）和分级的增加（p<0.05）而升高。肿瘤生长迅速的患者淋巴结转移发生率高于肿瘤生长缓慢的患者（p<0.01）。41例肿瘤生长缓慢的患者中有3例出现区域淋巴结转移。由于这3例患者平均无病生存38.7个月，故认为区域淋巴结清扫术对其生存有效。25例肿瘤生长迅速的患者中有9例出现进行性淋巴结转移。其中4例既有明显的肿瘤血栓又有淋巴结转移，2例有远处转移。这些患者即使术后预后也较差。淋巴结清扫术对有明显肿瘤血栓和/或远处转移的患者无价值。
