Prognostic factors of renal cell carcinoma.
OBJECTIVE
Determination of prognostic factors is essential for the management of renal cell carcinoma. Stage, histological grade and type, and performance status are now well known and commonly used. During the last decade numerous predictors of patient outcome were tested. This review summarizes the most important studies, explores and compares the results, and tries to respond to the question, "Today, what do we expect of clinical, molecular and genetic factors concerning survival of patients with renal cell carcinoma?"


METHODS
Based on MEDLINE literature searches we comprehensively reviewed the literature on the prognostic factors associated with the tumor, the patient and the treatment.


RESULTS
During the last decades numerous factors have been studied but few of them maintained independent significance in terms of overall survival as assessed by multivariate analysis. Results are more often controversial from one series to another. No known molecular or cytogenetic tumor marker has been identified to help diagnose, manage or confirm renal cell carcinoma remission, progression or relapse.


CONCLUSIONS
The classical prognostic factors remain histological grade, histological type, performance status, patient age, number and location(s) of metastatic sites, time to appearance of metastases and prior nephrectomy. The only striking advancement during the last few years has been the proven contribution of radical nephrectomy for metastatic disease in patients with good performance status.
Méjean
Arnaud
A
Service d'Urologie, Hôpital Necker-Enfants-Malades, Paris, France.
Oudard
Stephane
S
Thiounn
Nicolas
N
D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000145:classification* / Q000473:pathology / Q000556:secondary / Q000628:therapy; D018450:Disease Progression; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification* / Q000473:pathology / Q000628:therapy; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic; D011379:Prognosis; D012307:Risk Factors
D014408:Biomarkers, Tumor