Cukier J, Charbit L
J Urol (Paris). 1986;92(1):1-6.
Prognostic correlation between the pathologic stage and survival was evaluated in 270 patients with renal cancer treated by enlarged nephrectomy and regional lymphadenectomy. Postoperative mortality varied in proportion to the extent of the tumor: 2.8% for intracapsular cancer, 6.4% for cancers invading perirenal fat, 9.4% for those extending into renal vein, 27.2% for those invading inferior vena cava, 17.4% for those with lymph node invasion and 17.6% for the metastatic tumors operated upon. Overall uncorrected survival was 63.5% at 5 years and 30.9% at 10 years, survival depending therefore on the developmental stage of the cancer. Intracapsular tumor: uncorrected survival at 5 years, 79.7% and at 10 years, 48.8%. For tumors invading perirenal fat without other dissemination: uncorrected survival at 5 years, 70.8% and at 10 years, 16.6%. Tumor extending into renal vein without caval or lymphatic invasion or metastases: uncorrected survival at 5 years, 56.2% and at 10 years, 30%, without any statistical difference from the 2 previous stages. Cancer with inferior vena cava invasion: 11 patients operated, 3 postoperative deaths, 4 metastatic recurrences between 11 and 40 months, and 4 survivors without metastases 6 to 55 months after operation. Cancer with lymphatic dissemination: no survivor in complete remission after 5 years. Cancer with bone or visceral metastases: uncorrected survival at 3 years, 8.3% (single peripheral metastasis irradiated). No operated patient with metastases survived for 5 years. A new classification is proposed: Stage I: intracapsular cancer more or less propagated into the renal vein. Stage II: cancer invading the perirenal fat with more or less propagation into renal vein. Stage III: propagation to the inferior vena cava excluding any lymphatic involvement.(ABSTRACT TRUNCATED AT 250 WORDS)
对270例行扩大性肾切除术及区域淋巴结清扫术的肾癌患者，评估病理分期与生存之间的预后相关性。术后死亡率因肿瘤范围而异：包膜内癌为2.8%，侵犯肾周脂肪的癌为6.4%，延伸至肾静脉的癌为9.4%，侵犯下腔静脉的癌为27.2%，有淋巴结侵犯的癌为17.4%，接受手术的转移性肿瘤为17.6%。总体未校正的5年生存率为63.5%，10年生存率为30.9%，因此生存率取决于癌症的发展阶段。包膜内肿瘤：5年未校正生存率为79.7%，10年为48.8%。对于侵犯肾周脂肪但无其他播散的肿瘤：5年未校正生存率为70.8%，10年为16.6%。肿瘤延伸至肾静脉但无腔静脉或淋巴管侵犯或转移：5年未校正生存率为56.2%，10年为30%，与前两个阶段无统计学差异。侵犯下腔静脉的癌：11例接受手术，3例术后死亡，4例在11至40个月之间发生转移性复发，4例术后6至55个月无转移存活。有淋巴播散的癌：5年后无完全缓解的幸存者。有骨或内脏转移的癌：3年未校正生存率为8.3%（单个周围转移灶接受放疗）。无手术的转移患者存活5年。提出了一种新的分类：I期：或多或少蔓延至肾静脉的包膜内癌。II期：侵犯肾周脂肪且或多或少蔓延至肾静脉的癌。III期：蔓延至下腔静脉且无任何淋巴受累。（摘要截断于250字）
