We analysed retrospectively 97 patients with metastatic renal cell carcinoma who were managed at Seoul National University Hospital during the last 12 years. Sixty nine of the patients had metastatic disease at the initial diagnosis, and 28 had
metastasis after nephrectomy. Sixty three patients were men and 34 women. The mean age was 55 years Ninety one patients were followed to the end of their lives, Among 69 patients with metastatic disease at the initial diagnosis, weight loss was
found in
38 patients(55.1%) and gross hemataria was found in 33(47.8%). Twenty one patients(30.4%) had metastatic symptoms, Laboratory findings showed increased ESR(more than 20) in 57 patients(82.6%), anemia(hemoglobin less than 10.0) in 43(62.3%),
elevated
alkaline phosphatase in 33(47.8%), elevated SGOT/SGPT in 21(30.4), hypercalcemia(more than 10.5) in 15(21.7%). Lung was the most common metastatic site, 35 patients(50.7%) had pulmonary metastasis, and bone, liver, brain and other organs in the
order,
Overall one year, 2 year and 5 year survival rate was 50%, 9.8% and 0% respectively, and the mean survival of the patients was 14.5 months. Among 28 patients who had metastatic lesions after nephrectomy, 19 patients(68%) had metastasis within one
year
after nephrectomy. The age, sex clinical features, laboratory findings and metastatic locations were similar to the metastatic disease at the initial diagnosis. All the patients died within 2 years after metastasis, with the mean survival of 12.8
months.
Prognostic significances of various factors such as age, sex, gross hematuria, palpable mass, weight loss, metastatic symptoms, anemia, LFT, serum calcium level, alkaline phosphatase level, ESR, multiplicity of the metastasis and multiorgan
metastasis,
treatment modality were assessed. In patients with initial metastatic disease, weight loss, anemia, elevated serum alkaline phosphatase and multiple metastasis had the prognostic significance in univariate analysis(P<0.05), and weight loss and
anemia
was significant statistically in multivariate analysis (<0.05),and it was the same in patients with metastasis after nephrectomy, Taking these prognostic factors into consideration, the survival pattern of the individual patients can be assessed,
and
will be benificial in planing the adequate treatment modalities.
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