[Long-term survival in patients with metastatic renal cell carcinoma managed with conservative therapy: a report of two cases].

Case 1. A 58-year-old man underwent radical nephrectomy due to a tumor in the left kidney (renal cell carcinoma, clear cell subtype, G3, pT1bpN0) in 1988. Thirteen years later, he underwent surgical resection of metastases to lung and cerebrum and gamma ray knife resection of two other sites of metastases to cerebrum in 2001. He had no evidence of disease in April, 2003. Case 2. A 53-year-old man underwent radical nephrectomy due to a tumor in the right kidney (renal cell carcinoma, clear cell type, pT1apN0) in 1987. From 1996 to 2001, irradiation therapy to multiple metastases to thoracic vertebrae (50 Gy), rib (50 Gy), para-aorta lymph nodes (40 Gy), sacrum (44 Gy) and sternum (44 Gy), and surgical resection of dermal metastasis were performed. Paraplegia occurred due to regrowth of thoracic bone metastasis in December, 2001. In February, 2002, he died of septic shock caused by infection of decubitus. Surgical resection and palliative therapy of recurrent metastatic foci was useful to improve the quality of life and probably prognosis.