[Correlation between the mode of presentation of renal tumors and patient survival].
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.
Patard
Jean-Jacques
JJ
Service d'Urologie, CHU Pontchaillou, rue Henri Le Guilloux, 35033 Rennes. jean-jacques.patard@chu-rennes.fr
Bensalah
Karim
K
Vincendeau
Sébastien
S
Rioux-Leclerq
Nathalie
N
Guillé
François
F
Lobel
Bernard
B
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
Corrélation entre le mode de présentation des tumeurs du rein et la survie des patients.