title: [Our experience with renal adenocarcinoma (II): clinical course, diagnosis, and prognostic factors before surgical treatment].
abstract: OBJECTIVE
  We evaluated the form of presentation, clinical features and analytical values and their relationship with survival in renal cell carcinoma patients and analyzed the efficiency of different diagnostic and staging procedures.
  
  
  METHODS
  We reviewed the form of presentation, clinical features, staging procedures and analytical values of 229 consecutive renal cell carcinomas diagnosed at our hospital between 1975 and 1991.
  
  
  RESULTS
  Malaise and weight loss or symptoms different from those of the classical triad (hematuria, pain and a flank mass) are factors of poor prognosis and lower survival. The time of presentation of symptoms does not influence prognosis. Computerized tomography was found to be the best imaging technique, with a low sensitivity and a high specificity in our experience. We have found a correlation between hypercalcemia and lower survival, but not for the more advanced tumoral stage. There was a correlation between the levels of hemoglobin and alkaline phosphatase and survival: patients with hemoglobin levels less than 14 g/dl or alkaline phosphatase levels greater than 85 U/l had a lower survival rate and a more advanced tumoral stage.
  
  
  CONCLUSIONS
  Computerized tomography was found to be the best imaging technique. Symptoms different from those of the classical triad, malaise and weight loss, hypercalcemia, low levels of hemoglobin or high levels of alkaline phosphatase are factors of poor prognosis.
authors.affiliation: Servicio de Urología, Hospital Covadonga, Oviedo, Asturias, España.
authors.forename: M
authors.initials: M
authors.lastname: Rivas del Fresno
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández Gómez
authors.forename: A
authors.initials: A
authors.lastname: San Martín Blanco
authors.forename: J L
authors.initials: JL
authors.lastname: Sahagún Argüello
authors.forename: J L
authors.initials: JL
authors.lastname: Martín Benito
authors.forename: F
authors.initials: F
authors.lastname: Alonso Sainz
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000401:mortality; D000368:Aged; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D012680:Sensitivity and Specificity; D015996:Survival Rate
vernacular_title: Nuestra experiencia en adenocarcinomas renales (II): Clínica, diagnóstico y factores pronósticos antes del tratamiento quirúrgico.