Immunotherapy for malignant lesions in man using immunogenic ribonucleic acid

Metastatic renal cell cancer and radical nephrectomy: identification of prognostic factors and patient survival

Between January 1, 1970 and December 31, 1980 (followup 2 years or more) 158 patients with histologically proved metastatic renal cell cancer and no prior therapy were seen. Statistical analyses identified variables that significantly influenced survival, including grade of the primary lesion (p equals 0.002), weight loss of more than 10 per cent (p less than 0.0001) and multiple versus single metastases (p equals 0.0001). Cell type, soft tissue versus bone metastasis, age, sex, site and size of primary lesion, and delay in the diagnosis did not influence survival significantly. Adjuvant nephrectomy markedly influenced survival only in patients with solitary metastasis, low grade primary tumor and weight loss of less than 10 per cent (p equals 0.06). Based on this analysis a score system was constructed to help predict survival and the impact of new forms of therapy in the future.

The role of adjunctive nephrectomy in patients with metastatic renal cell carcinoma

The results of therapy for 78 patients with disseminated renal cell carcinoma are evaluated. Symptoms related to the primary tumor were noted in only 28 per cent of the patients and were not difficult to manage in those patients not undergoing nephrectomy. Adjuctive nephrectomy, therefore, is a more appropriate term than palliative nephrectomy when referring to removal of the primary tumor as part of an aggresive combined therapeutic approach. Of patients receiving an adjunctive nephrectomy those with osseous metastases only had a better 1-year survival rate (36 per cent) than those with metastases to other sites (18 per cent). Complete regression of metastases was noted in 12 per cent of patients treated with medroxyprogesterone acetate and adjunctive nephrectomy. The role of adjunctive nephrectomy combined with embolic infarction, hormonal therapy, chemotherapy and/or immunotherapy is discussed.