title: Lymphatogenous spread of renal cell carcinoma: an autopsy study.
abstract: OBJECTIVE
  We investigated the occurrence and extent of metastatic spread, especially regarding lymph nodes, of renal cell carcinoma.
  
  
  METHODS
  From 1958 to 1982, 554 cases of renal cell carcinoma were diagnosed at autopsy. Clinical data and autopsy findings were reevaluated, and the occurrence of lymph node metastases was analyzed by histological examination of retroperitoneal, mediastinal, supraclavicular, axillary and inguinal lymph nodes.
  
  
  RESULTS
  Distant metastases were revealed in 119 cases (21.5%), including 31 (5.6%) with single metastases. In 88 cases (16%) renal cancer was the cause of death. Lymphatogenous dissemination was detected in 80 cases of which 75 had additional, mostly multifocal metastatic spread. Consequently lymph node metastases restricted to the paracaval and/or para-aortic lymph nodes were noted in only 5 cases (0.9%).
  
  
  CONCLUSIONS
  Of the 554 cases of clinically unrecognized renal cell carcinoma almost all with lymphatic spread had additional distant metastases. Therefore, the therapeutic effect of extensive retroperitoneal lymph node dissection in association with radical nephrectomy seems to be low. However, more limited lymph node dissection may be useful, mainly as a staging procedure.
authors.affiliation: Department of Urology, County Hospital Karlskrona, Sweden.
authors.forename: J A
authors.initials: JA
authors.lastname: Johnsen
authors.forename: S
authors.initials: S
authors.lastname: Hellsten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D002292:Carcinoma, Renal Cell / Q000556:secondary*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged