The Characteristics of Renal Cell Carcinoma Patients, Who may Benefit from Radiotherapy and Post-Nephrectomy

Objective: A retrospective analysis of 251 patients with advanced renal cell carcinoma from 1985 to 1998 is presented. Purpose: The aim of this study was to assess the influence of post-operative radiotherapy on overall survival in renal cell carcinoma patients with pathological features and to determine a group of patients with the best results after nephrectomy and radiotherapy. Materials and methods: The medical records of 148 patients with stage B and 103 patients with stage C treated according to the Robson system were reviewed. Post-operative radiotherapy with megavoltage was given to 136 patients group II-R [+]. Patients who underwent nephrectomy, but did not receive radiation therapy, were the control group I-R [-]. This group consisted of 115 patients, with indications to post-operative radiotherapy. Overall survival for patients with: capsular infiltration, perinephric fat, renal pelvis, renal pedicle and renal vein invasion, lymph node involvement and three tumor sizes: 1–5, 6–10, >10 cm, histological grade G1, G2, G3 were evaluated. Actuarial curves for overall survival were calculated using the Kaplan–Meier method. Survival curves were compared using the log rank test. Results: The following parameters were statistically significant: the capsular infiltration and renal pelvis infiltration renal pedicle invasion tumor >5 cm The others: perinephric fat and renal vein invasion, lymph node involvement, tumor size ≤5 cm, histological grade G2, G3 were not statistically significant . Conclusions: We found post-operative radiotherapy to be the greatest benefit in patients with invasion of the capsule infiltration, renal pelvis, renal pedicle invasion and tumor >5 cm.