title: The use of the American Society of Anesthesiology Classification as a prognostic factor in patients with renal cell carcinoma.
abstract: OBJECTIVE
  We analyzed whether the American Society of Anesthesiology (ASA) classification could be used as a prognostic factor in renal cell carcinoma.
  
  
  METHODS
  ASA classification's impact on cancer-specific survival (CSS) and on overall survival in 145 patients submitted to radical or partial nephrectomy was evaluated, and was compared with clinicopathological variables.
  
  
  RESULTS
  CSS was influenced by ASA in uni- and multivariate analyses. Five-year CSS was 95.7, 71.1 and 39.8% for ASA 1, ASA 2 and ASA 3, respectively (p = 0.007). The ASA classification influenced the overall survival too (p < 0.001). When 18 patients with metastases were excluded, the CSS was 95.7, 83.9 and 42.9% for ASA 1, ASA 2 and ASA 3, respectively (p = 0.001). ASA 3 patients had ten times more metastases than ASA1 patients and two times more than ASA 2 patients (p = 0.001). ASA 3 patients had fewer incidental tumors (p = 0.043) than ASA 2 and 3 patients.
  
  
  CONCLUSIONS
  In this series, the ASA classification could be used as a prognostic factor in renal cell carcinoma.
authors.affiliation: Service of Urology, Department of Pelvic Surgery, Hospital AC Camargo, São Paulo, Brazil. steniozequi@uol.com.br
authors.forename: Stênio
authors.initials: S
authors.lastname: de Cássio Zequi
authors.forename: Eurico C R
authors.initials: EC
authors.lastname: de Campos
authors.forename: Gustavo C
authors.initials: GC
authors.lastname: Guimarães
authors.forename: Wilson
authors.initials: W
authors.lastname: Bachega
authors.forename: Francisco P
authors.initials: FP
authors.lastname: da Fonseca
authors.forename: Ademar
authors.initials: A
authors.lastname: Lopes
mesh_terms: D000328:Adult; D000776:Anesthesiology / Q000379:methods; D002292:Carcinoma, Renal Cell / Q000145:classification / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000401:mortality; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011379:Prognosis; D016016:Proportional Hazards Models; D013997:Time Factors; D016896:Treatment Outcome