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Sixty eight patients with renal cell carcinoma admitted to Seoul National University Hospital during s 11 year period between 1973 and 1983 are analyzed retrospectively. The most common symptom was hematuria but the classic triad of hematuria, flank pain and mass was present in only 9% of the patients. Symptom secondary to metastasis was an only initial presentation in 12% of the patients. Angiography demonstrated hypervascular tumor in 91% of the patients. CT scan also showed a high diagnostic accuracy, but in 1 patient, tumor was not detected by CT scan but by angiography. Bone metastasis was not correlated with serum alkaline phosphatase level. Liver scan is not indicated unless there are 2 or more abnormal values among liver function test including alkaline phosphatase, GOT, GPT, bilirubin. Radical nephrectomy is the treatment of choice, which was performed in 33 patients, and vena cavotomy was necessary in 2 patients. The majority of distant metastasis occurred within the first 2 years following definite treatment of the primary tumor and had a tendency to involve bone, lung, lymph node in the order of frequency. In 31 patients in 53, follow up for 3 years was possible. Patients with stage 1 disease showed 78% (7/9) 3 year survival. There was no significant difference in 3 year survival between stage 1 (33%) and stage II (33%). Only one patient with stage IV disease survived more than 3 years and average survival of stage IV was 11 months.
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