Radical surgery for renal cell carcinoma.

A modified radical nephrectomy to cope with renal carcinoma presenting at advanced stages, is evaluated. A total of 50 cases were treated in this hospital from 1962 to 1976. The poor results from treatment of renal cell carcinoma in the earlier years, have prompted the modification of the conventional radical nephrectomy to cope with this disease which is still frequently seen at advanced stages. The modification includes exclusion of distant metastasis. The adherent segment of colon is resected along with the tumour. The renal vessels are then isolated. If the IVC is involved by a right-sided tumour, it is resected along with the tumour. The ureter is then ligated and the tumour with the adrenal gland, the resected colon segment, regional lymph nodes and the IVC are removed in one block. 2 such patients who otherwise would have been considered inoperable have survived for over 3 years.