摘要： Abstract: Objective To report our data of patients with clinical stage T1-3N1-2M0 renal cell carcinoma (RCC) and explore the
biological behavior of this malignancy. Methods A total of 531 patients with no distant metastatic RCC underwent open
radical nephrectomy at our institution between 1988 and 2008, among whom 42 patients with histological nodal metastases had
successful surgical tumor resection. The clinical data and outcomes of the 42 patients were analyzed. Results Of those 42
patients, 19.0% had T1, 21.4% had T2, and 59.5% had T3 stage tumors; 42.9% had N1 and 57.1% had N2 stage tumors.
Tumor recurred in 30 (71.4%) patients after the surgery, and death occurred in 26 (61.9%) cases at the last follow-up; among
the recurrent cases, 83.3% (25/30) had multiple metastases at the initial recurrence. The median cancer-specific survival
(CSS) and disease-free survival (DFS) was 23 and 11 months in these cases, respectively. Multivariate analysis demonstrated
that Fuhrman grade (P =0.005), N stage (P =0.014) and T stage (P =0.037) were the independent predictors of CSS; Eastern
Cooperative Oncology Group (ECOG) performance status (PS) (P =0.002), tumor size (P =0.007), Fuhrman grade (P =0.009) and
N stage (P =0.019) were the independent predictors of DFS. Conclusion Patients with T1-3N1-2M0 RCC have poor prognosis. N
stage is an independent predictor of both CSS and DFS, suggesting that extended lymph node dissection should be performed
when suspicious enlarged nodal disease is found during surgery.