Zincke H, Sen S E
Department of Urology, Mayo Clinic, Rochester, Minnesota 55905.
J Urol. 1988 Jul;140(1):25-7. doi: 10.1016/s0022-5347(17)41475-3.
Of 21 patients who underwent bench surgery for renal malignancies (renal cell carcinoma in 16 and transitional cell carcinoma in 5) 15 also had autotransplantation and 6 did not. In 5 patients the contralateral kidney was removed simultaneously for synchronous bilateral renal malignancy, and 16 had cancer in a solitary kidney. In the 3 patients who underwent nephrectomy for complications after autotransplantation no evidence of residual tumor was noted on histopathological examination. Of 9 patients 1 (11 per cent) had local recurrence after successful autotransplantation (renal cell carcinoma). Two patients with transitional cell carcinoma died of metastatic disease. Treatment failed in 31 per cent of the 16 patients with renal cell carcinoma (metastatic disease in 4 and metastatic disease with local recurrence in 1). Removal of solitary or synchronous bilateral renal cell cancer by bench surgery with subsequent autotransplantation is effective. For high grade transitional cell carcinoma of a solitary kidney its value is doubtful without adjuvant systemic treatment.
21例接受肾脏恶性肿瘤（16例肾细胞癌，5例移行细胞癌）离体手术的患者中，15例同时进行了自体肾移植，6例未进行。5例患者因双侧同步性肾脏恶性肿瘤同期切除了对侧肾脏，16例患者肿瘤位于孤立肾。3例患者在自体肾移植后因并发症接受了肾切除术，组织病理学检查未发现残留肿瘤迹象。9例患者中，1例（11%）在成功进行自体肾移植（肾细胞癌）后出现局部复发。2例移行细胞癌患者死于转移性疾病。16例肾细胞癌患者中有31%治疗失败（4例发生转移性疾病，1例发生转移性疾病并伴有局部复发）。通过离体手术切除孤立性或双侧同步性肾细胞癌并随后进行自体肾移植是有效的。对于孤立肾的高级别移行细胞癌，若无辅助性全身治疗，其价值存疑。
