[The evaluation of surgical management for metastatic lesions of renal cell carcinoma].

The clinical experience with 29 renal cell carcinoma patients who underwent resection of their metastatic lesions was reviewed. Fourteen patients had no metastatic lesions when nephrectomy was performed initially (initial M0 group) and 15 patients already had detected metastases at diagnosis of their renal tumors (initial M1 group). The final point of follow-up was May 31, 1994. Eighteen patients (M0 9, M1 9) were curatively resected and 11 (M0 5, M1 6) underwent non-curative resection. In the curatively resected group, 7 patients (3 lung, 2 adrenal gland, 1 brain, 1 bone metastasis) were alive with no recurrence followed from 50 to 174 months. Eight died from tumor recurrences, 1 was alive with tumor recurrence and 2 died from other diseases. The 3-year and 5-year survival rates in the curatively resected group (16 patients, excluding 2 who died from other diseases) were 87.5% and 61.9%, respectively, according to the Kaplan-Meier method. On the other hand, the 3-year and 5-year survival rate in the non-curatively resected group were 36.4% and 27.3%, respectively. Between the curatively resected group and non-curatively resected group, a significant difference was shown concerning the survival rate (3 year: P = 0.0018, 5 year: P = 0.003, generalized Wilcoxon method). We concluded that curative resection was the most important prognostic factor in the treatment of metastatic lesions.