Surgical Treatment For Renal Cellcarcinoma (Report Of 159 Cases)

Objective:To improve the level of diagnosis and treatment of renal cell carcinoma.Methods:Retrospectively analyzed the clinical presentation,imaging character, surgical management,immuntherapy and prognosis of 159 cases of patients with renal cell carcinoma from Nov.1999 to Jan.2006 .Among them 37 cases show nephralgia, 32 cases show hematuria,1 case shows nephroma,10 cases show both nephralgia and hematuria,33 cases show hypertension,2 cases show fever,33 cases show anemia,15 cases show dyshepatia,,1 case shows varicocele and 79 cases are incidental carcinoma of kidney.All of the 159 cases of renal cell carcinoma underwent B-ultrasound examination,and 126 cases underwent CT examination,52 cases underwent MRI examination.The accuracy rate of diagnosis by B-ultrasound was 94.3%,by CT was 96.8%,by MRI was 96.1%.There were 136 cases of Fuhrman stageⅠ,16 cases of stageⅡ,7 cases of stageⅢ。Results:Radical nephrectomy was carried out for 142cases. Nephron-sparing surgery for 16 cases. Simple nephrectomy for 1case.Pathological examination showed that 104 cases were clear cell carcinoma,16 cases granular cell carcinoma,28 cases complex of the above two varieties,6 cases papilla adenocarcinoma,2 cases collecting duct carcinoma,1 case chromophobe carcinoma and 2 cases sarcomatoid carcinoma In this group ,130 cases have been followed up.The 1 year and 3 year survival rates were 96.9% and 89.2% respectively.4 cases died within 1 year:3 months,5 months,8 months and 11 months after operation. 10 cases died within 1~3 years:13~34 months after operation respectively.29 cases lost follow up.116 cases are still alive now,who have survived for 13 months ~ 6 years and 9 months,the mean survival duration was 3 years.Conclusions:B-ultrasound and CT were important method for the diagnosis of renal cell carcinoma.Prompt radical nephrectomy was the most effective treatment.And immuntherapy was a selectable treatment.