Prognostic score for patients with localized renal cell carcinoma treated by nephrectomy.
OBJECTIVE
To evaluate the feasibility of using combined clinical and histomorphometric features to construct a prognostic score for the individual patient with localized renal cell carcinoma.


METHODS
We studied 39 patients with pT1 and pT2 RCC who underwent radical nephrectomy between 1974 and 1983. Univariate and multivariate analyses were used to determine the association between various prognostic features and patient survival.


RESULTS
The most important and independent predictors of survival were tumor angiogenesis (P = 0.009), nuclear DNA ploidy (P = 0.0071), mean nuclear area (P = 0.013), and mean elongation factor (P = 0.0346). Combination of these variables enabled prediction of outcome for the individual patient at a sensitivity and specificity of 78% and 89%, respectively.


CONCLUSIONS
Our results indicate that no single parameter can accurately predict the outcome for patients with localized RCC. Combination of neovascularity, DNA content and morphometric shape descriptors enabled a more precise stratification of the patients into different risk categories.
Nativ
O
O
Department of Urology, Bnai Zion Medical Center, Lady Davis Carmel Medical Center, Haifa, Israel. dr_nativ@netvision.net.il
Sabo
E
E
Madeb
R
R
Halachmi
S
S
Madjar
S
S
Moskovitz
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D043925:Angiogenesis Inducing Agents; D019540:Area Under Curve; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004273:DNA, Neoplasm / Q000302:isolation & purification; D005240:Feasibility Studies; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011003:Ploidies; D011379:Prognosis; D012372:ROC Curve
D043925:Angiogenesis Inducing Agents; D004273:DNA, Neoplasm