[Diagnosis and treatment of sarcomatoid renal cell carcinoma].

Objective: To study the clinical diagnosis and treatment of sarcomatoid renal cell carcinoma, and to analyze the connection of prognosis with therapy.

Methods: 10 cases with sarcomatoid renal cell carcinoma from 1997 - 2007 in our hospital were analyzed, and the related literatures were reviewed.

Results: All patients were performed with operation, and pathologically diagnosed as sarcomatoid renal cell carcinoma. Cases with metastasis were performed with chemical therapy, biological therapy or radiotherapy after operation. Clinical stage (TNM) of 10 cases is T1N0M0 1 case, T2N0M0 3 cases, T3N0M0 1 case, T4N0M0 1 case, T2N0M1 3 cases, T4N0M1 1 case. 60% (6/10) of patients were diagnosed with metastasis or diffusion. In these 6 cases, 4 cases were diagnosed with pulmonary metastasis, 1 with brain metastasis, and 1 with osseous metastasis, and 1 with inferior vena cava tumor thrombus. The average life span of all 10 cases was 17 months, and cases with advanced stage was 8 months. Otherwise, the average survival time of cases with earlier stage was 30 months, and it was 21 months from diagnosis to metastasis.

Conclusion: Sarcomatoid renal cell carcinoma is a special type of renal cell carcinoma with features of high malignant and rapid progress. It is clinical rare and with bad prognosis. Operation is the first choice for the therapy, the effect of radiotherapy or chemical therapy is not obviously. The lung is main position for metastasis. Early diagnosis and treatment are effective to prolong the life span of patients, and the new therapy may be more important.