A Clinical Observation on 28 Cases of Hypernephroma / 대한비뇨기과학회지

ABSTRACT

Although, renal carcinoma represent 2 to 3% of all human cancers, the impredictable nature, and unique clinical and biological features of renal carcinoma place it among the most interesting of human malignancies. Total surgical excisions offers the only certain cure for nephrocarcinoma, but additional benefit may be achieved by utilization of adjuvantive methods including surgical excision of metastasis, radiation, chemotherapy, and immunotherapy. So, 28 patients with renal cell carcinoma were analyzed retrospectively in order to 1) determine the effectiveness of systemic chemotherapy-hormonal and non-hormonal, 2) identify the clinical features of renal cell carcinoma that may be important in prognosis and 3) characterize the paraneoplastic features of renal cell carcinoma. The classic triad of signs and symptoms including pain, hematuria, and palpable tumor mass presents in only 7%. Paraneoplastic syndrome occurred in up to 28.6% Metastasis was present at diagnosis in 25 % of the cases and developed within 1 year in an additional 10.7%. Surgery was employed to 23 patients for the purpose of complete cure of the disease or palliation and adjuvantive therapy was employed either to palliate symptoms or to attempt eradication of metastatic deposits to 9 patients with or without surgery. Most of metastatic disease was unresponsive objectively to either primary nephrectomy or to a variety of chemotherapy trial. Improving diagnostic capabilities and the introduction of more sophisticated diagnostic equipment promise to provide still earlier identification of patients with renal cell carcinoma and to allow surgical intervention at curable stages of disease.