Metastatic Processes and a Potential Indication of Treatment for Metastatic Lesions of Renal Adenocarcinoma

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Abstract
Renal adenocarcinoma findings from 307 autopsied cases with metastasis to 1 and 2 organs were investigated concerning the mode of metastasis. The lung was the most frequent site of metastasis to 1 organ (although the frequency was rather low (30%)) followed by bones (over-all), lymph nodes (over-all) and brain, involving frequently the thoracic spine and retroperitoneal lymph nodes. In patients with metastases to 2 organs a significant correlation was found between the pulmonary-tracheal lymph nodes and those to the lungs. Potential indications for treatment of metastatic lesions were lymphadenectomy and/or radiation therapy for the retroperitoneal and para-aortic lymph nodes, and resection of metastatic lesions in the lungs combined with lymphadenectomy and/or radiation therapy for the pulmonary-tracheal lymph nodes. In patients without lung metastasis lymphadenectomy and/or radiation therapy for the pulmonary-tracheal lymph nodes is not always necessary.