Prognosis in renal cell carcinoma: analysis of clinical course following nephrectomy.

The clinical courses and survivals of 159 patients who underwent nephrectomy for renal cell carcinoma are reviewed. A longer disease-free period after nephrectomy was correlated with significantly better survival. Among patients in whom metastases in the lungs or bones were detected after nephrectomy, those with between one and five pulmonary or solitary bone metastases, without definite increases in their number and size in the six months following their first appearance, survived significantly longer than patients with a similar number of metastases but which did increase in number and size in the following six months, or patients with six or more pulmonary or multiple bone metastases. Even when metastases detected after nephrectomy were confined to the lungs or bones throughout the observation period, the patients did not necessarily show significantly better survivals than patients with metastases detected in multiple sites.