CLINICOPATHOLOGICAL FEATURES OF RECURRENT RENAL-CELL CARCINOMA

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.