Hellsten S, Berge T, Linell F
Br J Urol. 1983 Apr;55(2):166-70. doi: 10.1111/j.1464-410x.1983.tb06546.x.
In a series comprising 235 clinically unrecognised renal carcinoma, metastatic spread was found in 56 cases (24%). In 82% of cases with metastases the spread involved more than one site. Lymphatic spread was diagnosed in 37 patients. Lymph node metastases were usually multiple and multifocal and were almost as common in the mediastinum as in the retroperitoneal space. In cases with involvement of these sites and/or supraclavicular nodes, concomitant metastases in the lungs were observed in 86% and in other organs in 11%. Since lymph node invasion is a strong indicator of systemic spread, the therapeutic benefit of radical lymphadenectomy seems very low, whereas a limited unilateral dissection is justified mainly for its value as a staging procedure.
在一组包含235例临床未识别的肾癌病例中，发现56例（24%）有转移扩散。在有转移的病例中，82%的转移涉及不止一个部位。37例患者被诊断为淋巴转移。淋巴结转移通常是多发和多灶性的，在纵隔和腹膜后间隙的发生率几乎相同。在这些部位和/或锁骨上淋巴结受累的病例中，86%的患者伴有肺部转移，11%的患者伴有其他器官转移。由于淋巴结侵犯是全身扩散的有力指标，根治性淋巴结清扫术的治疗益处似乎非常低，而有限的单侧清扫术主要因其作为分期手术的价值而合理。
