title: Renal cell carcinoma: a clinicopathological follow-up study after radical nephrectomy.
abstract: OBJECTIVE
  To examine the prognostic significance of performance status, tumour stage, histological subtype, nuclear grade and histological tumour necrosis (HTN) in a population of consecutive patients subjected to radical nephrectomy for renal cell carcinoma (RCC).
  
  
  METHODS
  The cohort consisted of 110 males and 86 females with a mean age of 66 years (range 39-88 years). The Eastern Cooperative Oncology Group performance status (ECOG PS) was determined in all cases. The tumours were staged according to the 2002 TNM classification of the American Joint Committee on Cancer. Histological subtype was diagnosed using the Heidelberg classification. Nuclear grading was performed by means of Fuhrman's method. The median follow-up period was 65 months (mean 83 months; range 1-232 months).
  
  
  RESULTS
  Median overall survival (OS) was 65 months and median cancer-specific survival (CSS) was 171 months. CSS was correlated with TNM classification, with the longest survival occurring for stage I and II tumours, shorter survival for stage III tumours and shortest survival for stage IV tumours (p<0.001). A significant difference in CSS was found between T1N0M0 and T2N0M0 tumours (p<0.01). A 15-year CSS of 100% was revealed in patients with tumours </=4 cm in size. There was a significant difference in CSS between low nuclear grade (NG; 1+2) and high NG (3+4) tumours (p<0.001). HTN and ECOG PS were found to be independent prognostic factors (p<0.01).
  
  
  CONCLUSIONS
  ECOG PS, TNM stage, nuclear grade and tumour necrosis were found to be independent prognostic factors for survival.
authors.affiliation: Section of Urology, Department of Surgery, The Gade Institute, Haukeland University Hospital, Bergen, Norway. dragomir.zubac@haukeland.no
authors.forename: Dragomir P
authors.initials: DP
authors.lastname: Zubac
authors.forename: Leif
authors.initials: L
authors.lastname: Bostad
authors.forename: Charlotta
authors.initials: C
authors.lastname: Gestblom
authors.forename: Björn
authors.initials: B
authors.lastname: Kihl
authors.forename: Tomas
authors.initials: T
authors.lastname: Seidal
authors.forename: Tore
authors.initials: T
authors.lastname: Wentzel-Larsen
authors.forename: August M
authors.initials: AM
authors.lastname: Bakke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000145:classification / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013548:Sweden