Saitoh H, Nakayama M, Nakamura K, Satoh T
J Urol. 1982 Jun;127(6):1092-5. doi: 10.1016/s0022-5347(17)54243-3.
In an analysis of the autopsy records of 1,828 patients with renal adenocarcinoma 424 nephrectomized and 1,404 nonnephrectomized cases were compared to explore the effect of nephrectomy on metastasis. Over-all, no significant difference was observed except for a high incidence of metastases to the brain and femur, and a low incidence of metastases to the ipsilateral adrenal and renal hilar lymph nodes in nephrectomized cases. No significant difference was seen between the nephrectomized and nonnephrectomized cases with metastatic involvement of 1 organ, with respect to the frequency with which any given organ was involved. There were 5 patients with metastasis in whom survival was 10 years or longer after nephrectomy. Lung metastasis was present in 4 cases and lymph node metastasis in 1. Of these 5 patients 3 had undergone nephrectomy only. The results failed to show any evidence of the effectiveness of nephrectomy or adjuvant therapy. It was inferred that the mode of metastasis and the clinical progress of patients after nephrectomy for renal adenocarcinoma are influenced more profoundly by characteristics of the tumor itself than by nephrectomy.
在一项对1828例肾腺癌患者尸检记录的分析中，比较了424例接受肾切除术的病例和1404例未接受肾切除术的病例，以探讨肾切除术对转移的影响。总体而言，除了肾切除病例中脑和股骨转移发生率较高，同侧肾上腺和肾门淋巴结转移发生率较低外，未观察到显著差异。在转移累及1个器官的肾切除病例和未肾切除病例之间，就任何特定器官受累的频率而言，未发现显著差异。有5例发生转移的患者在肾切除术后存活10年或更长时间。其中4例有肺转移，1例有淋巴结转移。这5例患者中，3例仅接受了肾切除术。结果未能显示肾切除术或辅助治疗有效性的任何证据。据推断，肾腺癌肾切除术后患者的转移方式和临床进展受肿瘤本身特征的影响比受肾切除术的影响更为深远。
