REPORT OF 337 PATIENTS WITH RENAL-CELL CARCINOMA EMPHASIZING 110 WITHSTAGE-IV DISEASE AND REVIEW OF THE LITERATURE

Background: In the literature, the interdependence of variables, inclu ding stage, sex, age, tumor size, therapy, and survival, is complex. T he size variable has heretofore received relatively little emphasis. M ethod: This was a retrospective evaluation of 337 patients with kidney cancer treated at the University of Illinois Affiliated Hospitals. Da ta were collected on stage, sex, age, tumor size, TNM stage, therapy, and survival. Statistical analyses included Kaplan-Meier 5-year surviv als, as well as multivariate analysis utilizing the Cox regression mod el. A subset of 110 patients with TNM Stage TV disease is further eval uated employing a multivariate analysis. The principal form of therapy was nephrectomy. Result: Five-year survivals by stage varied from 100 % for Stage I, 96% for Stage II, 59% for Stage III, to 16% for Stage I V. In the subset of 110 patients with TNM Stage IV disease, those with a single metastasis had better survivals than those with two or more. Those having nephrectomy had better survivals (P < 0.05). Therapy (in addition to nephrectomy) was curative (defined as cytotoxic chemother apy or immunotherapy) in 40 patients and palliative (defined as radiat ion to bone metastases, hormone therapy, or supportive) in 70 patients . Multivariate analysis of TNM Stage TV variable differences indicated that only tumor size differences and nephrectomy significantly affect ed survival. Conclusions: Of importance is the observation that among these patients, survival is directly correlated with tumor size. (C) 1 997 Wiley-Liss, Inc.