Surgical treatment of metastatic carcinoma of the kidney.

In cases of renal carcinoma with distant metastases, the prognosis is generally bad. The average survival time of these patients is usually a few mth after the diagnosis is made and palliative nephrectomy, in most cases has no effect on the development of metastases. However, in some cases where there is a single metastasis, nephrectomy associated with removal of the metastasis can be followed by a long period of remission. In this article, 3 cases with distant metastases in the thoracic area, treated in this way, are described. In 2 of these patients, recurrent growth occurred again after an interval of some yr, and these too were successfully removed. In one patient, a wide resection of the sternum was performed. All 3 patients are alive with no sign of recurrences. It seems possible that some renal tumors present with a lesser degree of malignancy. Aggressive surgery, both on primary and metastatic growth, seems justified in these cases.