Patients with renal cell carcinoma without distant metastasis prior to
nephrectomy were classified into a recurrent group (n=152) and a non-
recurrent group (n=271). We investigated the clinical features of recu
rrent patients after nephrectomy. The number of patients who presented
symptoms in the urinary tract and paraneoplastic symptoms were greate
r in recurrent group than in non-recurrent group. As to the serologica
l examination, recurrent patients had some abnormalities; predominantl
y increased levels of immunosuppressive acidic protein (IAP) and acute
phase products. The recurrent patients had larger tumors, and higher
stage and grade compared with non-recurrent patients. Analysis of the
interval of recurrence, and survival after recurrence showed that both
stage and grade were important factors, and that grade seemed to be a
more significant risk factor in predicting recurrence. However, in th
e low-grade patients, there were two types: those who died of cancer r
apidly and those who had a relatively long survival after recurrence.
We conclude that the stage of disease and the grade of malignancy are
important factors for determining the recurrence after nephrectomy, bu
t these factors cannot necessarily predict the prognosis after recurre
nce.