Influence of Nuclear Grade on Prognosis in Patients with Renal Cell Carcinoma Treated by Radical Nephrectomy

Cheon, Sung Yeop; Doo, Hwan Woo; Kim, Hyung Jin; Lee, Dong Guen

Abstract

PURPOSE: The aim of the study was to determine the prognostic factors influencing the survival rate in patients with renal cell carcinomas treated by radical nephrectomy.
MATERIALS AND METHODS
90 patients, with a renal cell carcinoma, who underwent a radical nephrectomy between January 1992 and December 2001, were retrospectively reviewed. The survival rate according to the prognostic factors, such as the 1997 TNM stage, tumor size, cell type and nuclear grade of the tumor, age and gender, tumor location and erythrocyte sedimentation rate (ESR), were analyzed using the Kaplan-Meier method. A univariate analysis, using log rank tests, was performed to evaluate the prognostic factors. A multivariate analysis was performed to determine which factors had an independent impact on the survival of patients with a renal cell carcinoma.
RESULTS
The overall 1- and 5-year cancer survival rates were 93.6 and 74.7%, respectively. The 1- and 5-year cancer survival rates by stage were 100 and 93.8% in stage I, 100 and 80.0% in stage II, 87.4 and 57.4% in stage III and 66.7 and 27.8% in stage IV (p<0.0001). The univariate analysis showed significant differences in the TNM stage and nuclear grade and the tumor size and the ESR. The multivariate analysis revealed that the TNM stage and nuclear grade of the tumor were the best prognostic indicators for a renal cell carcinoma.
CONCLUSIONS
The TNM stage, nuclear grade, size of tumor and enhanced ESR are important prognostic factors in renal cell carcinomas. The TNM stage and nuclear grade of the tumor are independent prognostic factors.