[Our experience with renal adenocarcinoma (II): clinical course, diagnosis, and prognostic factors before surgical treatment].
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.
Rivas del Fresno
M
M
Servicio de Urología, Hospital Covadonga, Oviedo, Asturias, España.
Fernández Gómez
J M
JM
San Martín Blanco
A
A
Sahagún Argüello
J L
JL
Martín Benito
J L
JL
Alonso Sainz
F
F
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
Nuestra experiencia en adenocarcinomas renales (II): Clínica, diagnóstico y factores pronósticos antes del tratamiento quirúrgico.