title: [Correlation between the mode of presentation of renal tumors and patient survival].
abstract: OBJECTIVE
  To establish a symptom score and to test its prognostic value in comparison with the usual histological prognostic criteria.
  
  
  METHODS
  388 renal tumours were classified into three symptomatic grades according to the circumstances of discovery: S1: incidental discovery, S2; patient presenting with haematuria or low back pain, S3: patient presenting with alteration of general state or symptomatic metastasis. The following prognostic criteria were studied: age, gender, tumour volume, symptom score, ECOG (0 vs 1 or more), stage (TNM 1997), Fuhrman grade, venous and adrenal invasion. Survival rates were compared by the Kaplan-Meier method (Log rank test). Multivariate analysis was performed according to the Cox model.
  
  
  RESULTS
  Tumours were classified as T1, T2, T3, T4 in 140 (36.1%), 73 (18.80%), 162 (41.8%) and 13 (3.4%) cases, respectively. 31 tumours were graded as G1 (8%), 167 as G2 (43%), 152 as G3 (39.2%) and 38 as G4 (9.8%), 143 tumours were classified as S1 (36.9%), 159 as S2 (41%) and 86 as S3 (22.10%). 45 patients were N+ (11.6%) and 54 were M+ (13.9%), The mean follow-up was 73 months. The significant parameters on univariate analysis were: ECOG, symptom score, TNM stage, grade, venous and adrenal invasion and tumour volume (p < 0.001), while symptom score, TNM stage and Fuhrman grade were significant on multivariate analysis (p < 0.001).
  
  
  CONCLUSIONS
  The symptom score is an independent prognostic factor in the same way as tumour stage and grade. This score could be used in a mathematical algorithm predictive of survival of patients with renal cancer.
authors.affiliation: Service d'Urologie, CHU Pontchaillou, rue Henri Le Guilloux, 35033 Rennes. jean-jacques.patard@chu-rennes.fr
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
authors.forename: Karim
authors.initials: K
authors.lastname: Bensalah
authors.forename: Sébastien
authors.initials: S
authors.lastname: Vincendeau
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rioux-Leclerq
authors.forename: François
authors.initials: F
authors.lastname: Guillé
authors.forename: Bernard
authors.initials: B
authors.lastname: Lobel
mesh_terms: D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy; D012189:Retrospective Studies; D013997:Time Factors
vernacular_title: Corrélation entre le mode de présentation des tumeurs du rein et la survie des patients.