Prognostic factors for survival of patients after curative surgery for renal cell carcinoma: multivariate analysis of 482 cases.
BACKGROUND
Even with curative surgery, renal cell carcinoma occasionally recurs in other organs, with fatal results. In this study, we identified independent prognostic factors for survival in patients with renal cell carcinoma after curative surgery.


METHODS
The records of 482 patients (mean age, 61.0 years; range, 17-90 years) who underwent curative surgery for renal cell carcinoma at Gifu University Hospital and its affiliated hospitals between 1991 and 2000 were reviewed. The average follow-up period was 42 months (range, 10-140 months). Clinical characteristics of the 482 patients were divided into three categories: patient factors (sex, age, performance status, and mode of tumor discovery), tumor factors (T classification, N classification, mode of infiltration, histological grade, and venous invasion), and treatment factor (whether or not adjuvant therapy with interferon-alpha was used). Stepwise multivariate Cox proportional hazards regression modeling was performed to identify independent determinants of survival.


RESULTS
Of the patient factors, performance status and mode of tumor discovery were independent factors predicting survival. Of the tumor factors, venous invasion and mode of infiltration were independent factors predicting survival. Use or non-use of adjuvant therapy was not significantly associated with survival. Overall, performance status, venous invasion, mode of infiltration, and histological grade were shown to be independent prognostic factors, in descending order of importance.


CONCLUSIONS
Performance status, venous invasion, mode of infiltration, and histological grade, in descending order, were the most important factors predicting survival after curative surgery for renal cell carcinoma.
Uno
Masahiro
M
Department of Urology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan. 1119-mugu@mue.biglobe.ne.jp
Fujimoto
Yoshinori
Y
Takada
Toshihiko
T
Ishida
Kenichiro
K
Kubota
Yasuaki
Y
Katoh
Seiichi
S
Hagiwara
Noriyasu
N
Minamidate
Yuzuru
Y
Yokoi
Shigeaki
S
Deguchi
Takashi
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006304:Health Status; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis