title: Prognostic factors and long-term survival in renal cell cancer patients.
abstract: OBJECTIVE
  The long-term survival of renal cell cancer (RCC) patients is not reported in the recent literature. This study evaluated the significance of known clinical prognostic factors and long-term survival in a large centrally treated Finnish RCC population.
  
  
  METHODS
  In 948 patients diagnosed between 1964 and 1997 the relative overall survival (OS) was calculated up to 25 years by Bayesian analysis and the life-table method. The effect of gender, age, cancer stage, TNM (tumour, node, metastasis) class, Fuhrman's grade, symptoms and year of diagnosis was studied.
  
  
  RESULTS
  Women and patients aged 40-49 years had better survival. Stage, TNM class and grade proved relevant for prognosis. The relative 5-year overall survival was 88%, 63%, 65% and 15% in stages I-IV, respectively. Asymptomatic patients had better survival, their median survival being 8.1 years as against 9.1 years in patients with local symptoms and only 1.7 years in patients with systemic symptoms. The year of diagnosis was not significant in prognosis.
  
  
  CONCLUSIONS
  The most important explanatory factors were stage, age and clinical presentation of the tumour. RCC patients showed diminishing overall survival in the follow-up, with no plateau; almost 57% of patients developed local recurrence or distant metastases even after a very long disease-free interval.
authors.affiliation: Tampere University Hospital, Tampere, Finland. k.sunela@pshp.fi
authors.forename: Kaisa L
authors.initials: KL
authors.lastname: Sunela
authors.forename: Matti J
authors.initials: MJ
authors.lastname: Kataja
authors.forename: Eero T
authors.initials: ET
authors.lastname: Lehtinen
authors.forename: Tapio K
authors.initials: TK
authors.lastname: Salminen
authors.forename: Paula M
authors.initials: PM
authors.lastname: Kujala
authors.forename: Juha P
authors.initials: JP
authors.lastname: Virman
authors.forename: Pirkko-Liisa I
authors.initials: PL
authors.lastname: Kellokumpu-Lehtinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001499:Bayes Theorem; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology; D002648:Child; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data; D055815:Young Adult