Methods and prognosis of the extirpation of pulmonary metastases following tumor nephrectomy.

Abstract

Nephrectomy was performed in 938 patients with renal carcinoma between the years 1960 and 1986. The cumulative survival rate was 78.7 +/- 2.7% after 1 year; 62.9 +/- 3.2% after 3 years; 52.4 +/- 3.5% after 5 years, and 38.0 +/- 4.1% after 10 years. Of this group, 39 patients with lung metastases underwent surgery of their metastases following radical surgical removal of their primary tumor. Using the so-called actuarial method of analysis, the cumulative survival rate of this group was 66.7 +/- 15.1% 1 year after the lung surgery; 47.6 +/- 16.3% after 3 years and 32.7 +/- 15.7% after 5 years. The survival rates were correlated with the number of metastases, the operative techniques employed, and with the time interval between primary tumor removal and the appearance of secondary lung metastases. A comparison was made between those patients who underwent curative lung surgery (R0 group) and those with residual tumor (R+ group). Follow-up of the tumor status at the end of the study of the 39 patients is presented.