Prognostic factors of renal cell carcinoma: A multivariate analysis

Abstract

Background and Objectives: To establish appropriate therapeutic modalities for renal cell carcinoma (RCC), informations on the factors affecting prognosis of patients are essential. For this purpose, multivariate analysis including a large set of variables is necessary. Methods Prognostic significance of 14 clinical factors and 19 histologic factors including counting of silver‐stained nucleolar organizer regions (AgNORs) were evaluated in 96 patients. Age of patients ranged from 41 to 85 (median 59) yr with a male to female ratio of 4:1. The tumors were staged based on the TNM classification as follows: 7 in stage I, 58 in stage II, 15 in stage III, and 11 in stage IV. Results The overall and metastasis‐free survival rates in all patients were 80.1% and 72.7%, respectively. Multivariate analysis using Cox's proportional hazards model performed on the factors proved to be significant at the univariate analysis. Univariate analysis revealed four clinical factors including presence of macroscopic hematuria, symptoms such as pain and palpable abdominal mass, anemia, and adjuvant therapy, and nine histologic factors, including AgNOR count, to be significant for survival. Multivariate analysis showed that anemia, pathological stage, and AgNOR count were independent factors for overall survival of patients. The AgNOR count, in particular, is the only predictive factor for metastasis‐free survival. Conclusions Among various clinicopathological factors, anemia, pathological stage, and AgNOR count are significant prognosticators of RCC. The AgNOR count is also predictive factor for metastasis‐free survival. J. Surg. Oncol. 1998;68:11–18. © 1998 Wiley‐Liss, Inc.

Prognostic Factors in Renal Cell Carcinoma: Association of Preoperative Sodium Concentration with Survival

“…Similarly, variables, such as calcium, lactate dehydrogenase, and alkaline phosphatase, were significant on univariate testing for survival in our patient population, in agreement with previous reports (11,25,26). Platelet count (27) and Hb (3,11,28) have previously been associated with poorer survival in patients with RCC and were significant on univariate testing, but not multivariate analysis in this study.…”

Tissue Array-Based Predictions of Pathobiology, Prognosis, and Response to Treatment for Renal Cell Carcinoma Therapy

“…Currently, markers relating to tumor proliferation, growth, angiogenesis, and loss of cell adhesion among others are being evaluated for their potential as prognostic factors. Increased staining of proliferating cell nuclear antigen (27), , and silverstaining nucleolar organizing region (29) have all been shown to correlate with poor survival in small studies of patients with renal cell carcinoma. Argyrophilic nucleolar proteins have also been shown to be an independent prognostic indicator (30).…”

VEGF, COX-2, and PCNA expression in renal cell carcinoma subtypes and their prognostic value

“…To date, tumor stage and grade have been considered the most important prognostic parameters for patients with RCC [1]. In many cases, however, these parameters were insufficient to predict the clinical behavior of RCC [2,3]. Patients with RCC who present with the same stage of disease demonstrate significant variations throughout the clinical course of their cancer [4].…”