PULMONARY METASTASIS FROM RENAL CELL CARCINOMA
1979 Volume 70 Issue 6 Pages 668-677
Details
1979 Volume 70 Issue 6 Pages 668-677
During a 25 year period from 1953 to 1977, a total of 104 cases of renal cell carcinoma were treated at the Jikei University Hospital. In 31 out of these 104 cases (30%) pulmonary metastasis was observed. Of these 31 cases, pulmonary metastasis was noted initially in 12 cases, and in the remaining 19 cases it occurred after nephrectomy. The time elapsed from the treatment of primary lesion to the detection of pulmonary metastasis was less than one year in 12 cases (63%), one to 2 years in 5 cases, 4 years and 4 months in one case, and 7 years in one case.
The treatment used for pulmonary metastasis included pneumectomy in one case, radiotherapy in 3 cases, chemotherapy in 15 cases and hormonal therapy in 11 cases.
In one case which underwent pneumectomy, metastasis to the lung was detected one year and 1 month after nephrectomy, for which pneumonectomy was performed. This patient has been well without showing relapses for these 4 years and 11 months.
Among 3 cases treated by radiotherapy, objective improvement was noted in one case, and in the other 2 cases there was no improvement. In the one effective case metastasis of carcinoma to the lung was found 5 months after nephrectomy, but it disappeared following irradiation of 5, 000 rads by Linac. Since then 6 years have passed without any recurrence of carcinoma.
Fifteen cases were treated with chemotherapeutic agents: three drugs (mitomycin C, 5-fluorouracil and cytosine arabinoside) were used combinedly in 9 cases, 4 drugs (actinomycin D, vincristine, methotrexate and cyclophosphamide) combinedly in 4 cases, and 5-fluorouracil dry syrup was used in 3 cases. Out of these 15 cases, objective improvement was observed in 3 cases (20%): namely, one case received three drugs (mitomycin C, 5-fluorouracil, and cytosine arabinaside) combinedly and 2 cases received 5-fluorouracil dry syrup. In all of these three cases metastasis to the lung was detected after nephrectomy. Both of 2 cases treated 5-fluorouracil dry syrup had a complete remission by chest X-ray examination. They remained well without recurrence of carcinoma in 9 and 6 months, respectively.
Hormonal agents used were progesterone and testosterone. In none of the 11 cases treated with these agents remission of metastatic lesion was confirmed by chest X-ray examination.
