Flamm J, Wöber L
Urologische Abteilung, Wilhelminenspitals der Stadt Wien.
Wien Klin Wochenschr. 1987 Dec 18;99(24):838-42.
A report is presented on 78 patients with metastatic renal cell carcinoma (RCC, Robson III and IV). The average survival time was 2.1 years after nephrectomy, 1.1 years after embolization and only 0.65 years in the patients who underwent no surgery at all. As there is still not known effective systemic cytostatic therapy for this type of tumour, there is no doubt about the priority of nephrectomy. The indication for nephrectomy is limited by the feasibility of total removal of the metastases. An extension of this indication limit has not improved the survival rate. There is no difference in survival rate between patients with removable local, as opposed to operable distant metastases. In those cases where nephrectomy was not possible the patients did better after embolization than with no surgery at all.
本文报告了78例转移性肾细胞癌（RCC，罗布森III期和IV期）患者的情况。肾切除术后平均生存时间为2.1年，栓塞术后为1.1年，而完全未接受手术的患者仅为0.65年。由于目前尚无针对此类肿瘤有效的全身细胞毒性治疗方法，肾切除术的优先性毋庸置疑。肾切除术的指征受转移灶能否完全切除的可行性限制。扩大该指征范围并未提高生存率。可切除的局部转移患者与可手术切除的远处转移患者的生存率并无差异。在无法进行肾切除术的病例中，患者接受栓塞术后的情况比完全不手术要好。
