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Abstract
A series of 58 subjects with renal carcinoma was studied with respect to extrarenal tumour spread—both direct and metastatic—at the time of perifascial nephrectomy combined with adrenalectomy and, in 41 patients, lymphadenectomy. Analysis of variance was used for assessing the associations between tumour spread and various clinical and morphological variables.
Metastases were present in non-hilar perirenal adipose tissue in 22% in the homolateral adrenal in 10% in lymph nodes and/or lymph vessels in 22%. Spread exclusively to non-hilar perirenal adipose tissue and/or the adrenal occurred in 14%. Extrarenal spread inside the renal fascia was observed in 38%.
The incidence and extent of metastases were significantly partially correlated to the maximum diameter of the tumour as well as to its cell type. Metastatic spread to lymph nodes and/or vessels was significantly partially correlated to tumour cell type. The erythrocyte sedimentation rate in renal carcinoma was significantly higher in women than in men and significantly partially correlated to tumour diameter, tumour cell type and age of the patient.
These studies indicate that the cell type grouping used can be of value in predicting the prognosis of renal carcinoma.
The investigation strongly suggests that perifascial nephrectomy combined with adrenalectomy and retroperitoneal lymphadenectomy should be performed in cases of renal carcinoma.
For the understanding of how tumour spread is dependent on different variables a multiple analysis is important.