1981 Volume 72 Issue 3 Pages 278-287
Based on observation made on 202 cases of renal cell carcinoma during a 14-year-period from 1965 through 1978, a retrospective study was made of the relationships between the stage and grade and the prognosis. The results obtained are the followings:
1) The 5-year relative survival rate was 75% for stage I, 77.5%, for stage II, 53.8% for stage III and 0% for stage IV. These figures clearly indicate that the stage of disease is one of the important determinant factors of the prognosis.
2) The grade-related 5-yeas relative survival rate was 77.5% for grade I, 59.8% for grade II, 37.2%, for grade III and 17.4% for grade IV. It became thus obvious that the prognosis of the disease quite well reflects its grade.
3) Among stage I cases those of lower grade tended to have a higher survival rate. However, grade III cases gave a 5-year relative survival rate of 71% and there were no striking differences among 4 grades in survival rate.
4) Among stage III cases those of low grade (grade I+II) had a 5-year relative survival rate of 75.9%, while the corresponding value for those of high grade (grade III+IV) was 32.3%. A similar trend was observed with stage IV cases. The grade of disease was thus shown to be a major determinant factor for prognosis.
5) Our study has shown that the proportions of lower grade were larger in lower stage carcinoma and higher grade in higher stage, indicating that the grade of the disease is a determinant of its stage. The above mentioned fact points out the necessity of studying the prognosis of renal cell carcinoma in relation to the grade as well as to the stage of the disease.
6) The 10-year crude survival rate, recurrence rate and the incidence of metastasis, which was first seen more than 10 years after operation, for stage I renal cell carcinoma were 30%, 70% and 3/7 (43%), respectively. It was felt important, therefore, not to take the malignancy easy even in such an early stage and to make all-out efforts to treat the cancer and prevent its relapse.
