title: Pre-operatively determined prognostic factors in metastatic renal cell carcinoma.
abstract: OBJECTIVE
  The aim of this study was to clarify the pre-operatively determined factors affecting the prognosis in patients with metastatic renal cell carcinoma (RCC).
  
  
  METHODS
  We analyzed 69 patients with metastatic RCC who received nephrectomy. Multivariate analysis by Cox's proportional hazards model and survival studies were applied.
  
  
  RESULTS
  Tumor thrombus in a renal vein or vena cava was the most significant poor-prognostic factor, followed by multiple-organ metastases and three or more abnormal findings of factors related to acute-phase proteins, in this order. Seven patients having these three risk factors died of cancer within 7 months after nephrectomy. On the other hand, half of the patients without risk factors survived for more than 2 years.
  
  
  CONCLUSIONS
  Risk status should be used for selection of metastatic-RCC patients for treatment of the primary site.
authors.affiliation: Department of Urology, Sapporo Medical University School of Medicine, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Miyao
authors.forename: T
authors.initials: T
authors.lastname: Oda
authors.forename: M
authors.initials: M
authors.lastname: Shigyou
authors.forename: K
authors.initials: K
authors.lastname: Takeda
authors.forename: N
authors.initials: N
authors.lastname: Masumori
authors.forename: A
authors.initials: A
authors.lastname: Takahashi
authors.forename: H
authors.initials: H
authors.lastname: Kitamura
authors.forename: T
authors.initials: T
authors.lastname: Tsukamoto
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism; D000704:Analysis of Variance; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000556:secondary / Q000601:surgery / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000601:surgery / Q000628:therapy; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D009392:Nephrectomy; D011379:Prognosis; D016016:Proportional Hazards Models; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000473:pathology; D018570:Risk Assessment; D014463:Ultrasonography; D014684:Venae Cavae / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D000209:Acute-Phase Proteins; D018931:Antineoplastic Agents, Hormonal; D017258:Medroxyprogesterone Acetate