Golimbu M, Joshi P, Sperber A, Tessler A, Al-Askari S, Morales P
Urology. 1986 Apr;27(4):291-301. doi: 10.1016/0090-4295(86)90300-6.
Three hundred twenty-six patients treated at New York University from 1970 to 1982 were studied for survival in relationship to surgical stage, type of therapy, and pathologic characterization of the primary tumor. At the time of diagnosis 25.5 per cent of tumors were Stage I, 15 per cent Stage II, 28.5 per cent Stage III, and 31 per cent Stage IV. The retrospective study showed that patients with tumor confined within the capsule achieved the highest five- and ten-year survivals of 88 per cent and 66 per cent, respectively. Survivals decreased as tumor invaded perirenal fat (67% and 35%) or regional lymph nodes (17% and 5%). Tumor invasion into the renal vein alone did not significantly change five-year survival (84%) but lowered ten-year survival to 45 per cent. Patients with metastases at the time of nephrectomy did poorly regardless of site of metastases or kind of adjuvant therapy, except for those managed by surgical extirpation of the secondary lesion. Certain tumor characteristics were associated with a better prognosis, e.g., size below 5 cm in diameter, lack of invasion of collecting system, perirenal fat or regional lymph nodes, and predominance of clear or granular cells growing into a recognizable histologic pattern.
对1970年至1982年在纽约大学接受治疗的326例患者进行了研究，以探讨其生存率与手术分期、治疗类型及原发肿瘤的病理特征之间的关系。在诊断时，25.5%的肿瘤为I期，15%为II期，28.5%为III期，31%为IV期。回顾性研究表明，肿瘤局限于包膜内的患者5年和10年生存率最高，分别为88%和66%。随着肿瘤侵犯肾周脂肪（67%和35%）或区域淋巴结（17%和5%），生存率下降。仅肿瘤侵犯肾静脉对5年生存率（84%）无显著影响，但10年生存率降至45%。肾切除时已有转移的患者，无论转移部位或辅助治疗类型如何，预后均较差，但经手术切除继发灶的患者除外。某些肿瘤特征与较好的预后相关，例如，直径小于5 cm、未侵犯集合系统、肾周脂肪或区域淋巴结，以及透明或颗粒细胞为主且生长成可识别的组织学模式。
