[Renal cell carcinoma. Comparative analysis of the prognostic significance of the WHO-classification and the Störkel's prognostic score].
Due to the increasing epidemiological importance of renal cell carcinoma (RCC) in the past, several studies have been undertaken to evaluate a variety of parameters in view of their aptitude for reliably predicting individual prognosis. Currently, staging according to the TNM classification and pathohistological nuclear grading of the tumor is most widely used for determining prognosis. In the latest edition of the TNM system, a subdivision of the stage pT1 into the stages pT1a and pT1b has been established. Analyzing a total of 129 patients with a postoperative follow-up period of 60 months after radical nephrectomy, we investigated the TNM classification in regard to its prognostic potential with emphasis on the new subdivision of the stage pT1. Furthermore, the results were compared to Störkel's prognostic score, which was first described in 1990 as a useful tool for predicting individual prognosis in patients with RCC. In conclusion, our study demonstrates that subdivision of the stage pT1 into the stages pT1a and pT1b did not result in any improvement concerning the aptitude of the TNM classification to predict individual prognosis. In comparison, Störkel's prognostic score has statistically proven to be superior to the TNM classification in regard to its prognostic potential. According to our experience, determination of Störkel's prognostic score can be easily performed by the pathologist without much expense in the course of daily routine diagnostic procedures. Therefore, we strongly recommend Störkel's prognostic score as the parameter of choice to reliably predict individual prognosis of patients suffering from RCC.
Pathologisches Institut, Carl-Thiem-Klinikum Cottbus. s.gunia@ctk.de
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Gunia
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D005858:Germany; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology*; D008297:Male; D009367:Neoplasm Staging / Q000379:methods* / Q000592:standards; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods* / Q000592:standards; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D014944:World Health Organization