[Extensive nephrectomy in severe forms of cancer of the kidney in the adult].

Resection of renal tumours may be useless when the staging procedures reveal that the disease is too far advanced. A retrospective study of 100 radical nephrectomies for renal cell carcinoma distinguished the following groups: advanced cancers in young patients; cancers in patients over the age of 70 years. Despite the limited follow-up of this series, the study of survival demonstrates the following points: the difficulty of predicting the degree of lymph node involvement on pre-operative staging, the value of an anterior sub-costal and abdominal approach which facilitates radical nephrectomy in elderly and fragile patients, the poor prognosis of lymph node invasion and metastases, although some patients have survived for 12 months after resection of metastatic tumours.