Results of radical nephrectomy in 178 cases of renal cell adenocarcinoma.

One hundred and seventy-eight patients with renal cell adenocarcinoma were classified by stage and treated by radical nephrectomy. A transabdominal approach was used in 92% of cases and lymphadenectomy was not performed unless ipsilateral hilar nodes were involved. Survival rates are presented in the form of life-table curves. These curves indicate that survival depends on the stage of the disease at the time of initial treatment; about 80% of patients with stage 1 lesions (tumour confined to the kidney) survived for 10 years compared with only 30% to 35% of stage 2 (involvement of perinephric fat) and stage 3 (involvement of renal vein or regional lymph nodes) patients and less than 10% of stage 4 (metastatic spread) patients. Radical nephrectomy appears to be the best method of treatment for patients with stage 1, 2 or 3 lesions. Simple palliative nephrectomy may be indicated in selected patients with stage 4 lesions.