[The clinical significance of the morphological characteristics of kidney cancer in middle-aged and elderly subjects].
The morphological characteristics of kidney carcinoma was studied in 124 elderly and old-aged patients who underwent nephrectomy. Clear-cell carcinoma was found in 65 (52.4%), granular cell carcinoma in 18 (14.5%), glandular carcinoma in 11 (8.9%), polymorphocellular carcinoma in 13 (10.5%), and mixed carcinoma in 17 (13.7%) patients. In homogeneous histological form of carcinoma 82 out of 94 tumors had areas of various degree of differentiation. In this group of patients with clear-cell carcinoma, more highly differentiated forms prevailed in 30 and less differentiated forms in 28 patients. Similar indices were 7 and 10 in granular cell carcinoma and 4 and 3 in glandular carcinoma, respectively. In prevalence of differentiated areas, 5-year survival was 63.6% in clear-cell carcinoma 42.9% in granular cell carcinoma, and 50% in glandular carcinoma. In prevalence of areas which were less differentiated 20.8%, 30%, and 0 patients, respectively, lived for 5 years. In the group of 13 patients with polymorphocellular carcinoma only one patient lived for 2 years while the others died within one year. Six patients died in the immediate postoperative period, in 6 of them postmortem examination revealed multiple distant metastases which were not recognized during the operation. The authors believe that operation is not indicated in elderly and old-aged patients with polymorphocellular carcinoma because the prognosis is very unfavourable. In predicting the results of surgery, of primary importance is not the presence of cells of moderate and low differentiation, but their percentage ratio to the highly differentiated cells. Clear-cell carcinoma with predominance of highly-differentiated cells takes a more favourable course.
Igel'nik
A M
AM
Kudriavtsev
Iu V
IuV
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality / Q000473:pathology; D009392:Nephrectomy; D011379:Prognosis
Klinicheskoe znachenie morfologicheskoĭ kharakteristiki raka pochki u lits pozhilogo i starcheskogo vozrasta.