Urological aspects of surgical management for metastatic renal cell cancer.

At the time of diagnosis one-third of patients with renal cell cancer are found to have metastatic spread. The patient's general condition and biological age as well as the resectability of the primary and/or secondary tumor decide whether surgery is indicated. Of our 44 patients, 12 underwent extirpation of metastases; 5-year survival was 47%. This is in agreement with published data. Patients with renal cell cancer and a solitary metastasis are, therefore, good candidates for surgery. In the presence of disseminated metastatic spread there is currently no place for tumor-reducing surgery because of the lack of effective adjuvant treatment modalities.