[Prognostic factors in renal-cell carcinoma treated surgically: analysis of a cohort of 345 cases].

Objective: To assess the prognostic role of clinical and pathological variables in patients with renal-cell carcinoma (RCC) treated surgically.

Material And Methods: We retrospectively analyzed our database of 394 consecutive patients with renal tumors. We excluded those with hereditary conditions, benign tumors or histological diagnosis other than RCC. The variables evaluated were weight loss, performance status, thrombocytosis, tumor diameter, nuclear grade, lymph node invasion and metastases. The main endpoint was cancer-specific survival (CSS). We performed univariate and multivariate analysis to determine prognostic factors.

Results: We identified 345 patients with RCC treated surgically between 1980 and 2009. After a median follow-up of 32 months, 23% died from cancer; they had larger tumors (p<0.0001), higher nuclear grade (p<0.0001) and lymphovascular invasion (p<0.0001). The 5- and 10-year CSS was 97.6 and 97.6% for stage I, 75.3 and 63.8% for stage II; 62.3 and 55.5% for stage III; 16.5 and 11.0% for stage IV (p<0.0001). All variables were associated with CSS on univariate analysis. On multivariate analysis tumor size, thrombocytosis, nuclear grade, lymph node invasion and metastases were independently associated with cancer-related mortality.

Conclusion: Our findings confirm the potential role of tumor size, nuclear grade, lymph node invasion and metastases. Thrombocytosis also has a prognostic role in patients with renal-cell carcinoma.