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May 13, 1968

Cancer of the Urogenital Tract: Kidney: Locally Advanced and Metastatic Renal Adenocarcinoma

JAMA. 1968;204(7):603. doi:10.1001/jama.1968.03140200043010

Although the majority of patients with advanced and metastatic renal cancer die of their disease, there are some long-term survivors. The natural history of this disease is often characterized by unexplained remissions. Causality of renal cancer in experimental and clinical terms is a fascinating subject. The kidney has been shown to be a target organ for hormones and is considered to have endocrine functions of its own. The relationship between hormones and renal neoplasia will be presented in the definition of its pathogenesis and the therapeutic applications that follow.

The attributing of successful regression of metastases from hypernephroma to a specific agent or maneuver demands careful review. With only a few exceptions, the practice of removing a primary cancer despite dissemination is rarely advocated in oncologic practice. The case for nephrectomy—palliative vs curative—must be examined and considered in terms of newer concepts in cancer immunology. Whereas a decade ago this