Management of distant solitary recurrence in the patient with renal cancer. Contralateral kidney and other sites.
About 25% to 57% of patients with RCC exhibit overt evidence of metastatic disease at the time of initial presentation. These patients have an average survival of about 4 months, and only 10% of them survive 1 year. Metachronous metastatic disease may develop in approximately 50% of patients who have undergone a presumably curative radical nephrectomy. Seventy percent of these patients relapse within the first year and manifest a median survival of about 11 months. The incidence of solitary metastatic lesions in patients with RCC ranges from 1.6% to 3.6%. In reality, the vast majority of these patients have evidence of subclinical, multifocal, micrometastatic disease and ultimately succumb to metastatic RCC. However, a 5-year survival rate of 35% to 50% can be achieved in properly selected patients using aggressive surgical treatment as a major component of therapy. In large part, insightful patient selection is predicated upon an understanding of the unique biologic and clinical issues relevant to each organ site of involvement.
Department of Urology, Northwestern University Medical School, Chicago, Illinois.
J M
JM
Kozlowski
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000628:therapy*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000628:therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000628:therapy*