Epidemiology and Prognostic Factors for Survival of Clear Cell Renal Carcinomas

Abstract

Tumor size, histologic grade, and TNM classification characterize kidney tumors and provide a useful prognosis for predicting survival in research and medicine. Our objective was to determine the postoperative survival of operated patients with a diagnosis of clear cell renal carcinomas (CCRC) and to evaluate its relationship with other prognostic factors. Age, sex, clinical presentation, size, Fuhrman nuclear grade, tumor-nodule-metastasis (TNM) stage, and the presence of local invasion were retrospectively analyzed in 66 patients operated on for clear cell renal carcinomas. Clinical follow-up was performed for 5 years to determine postoperative survival. During the follow-up period, 17 deaths occurred, with the cancer-specific survival rate being 77%. The presenting symptoms of the tumor that led to the diagnosis were not related to postoperative survival. The estimated survival for stages T2 was 100%, for T1 it was 93%, and for T3 it was 55%. No patients were found in stage T4. The lower Fuhrman grades (I and II) had an 85% survival rate, while the higher grades (III and IV) had a 53% survival rate. Survival rates also varied depending on the type of adjacent tissue that was affected. Specifically, survival decreased to 80% when infiltrating the renal capsule, 70% when infiltrating the perirenal tissues, and 28% when invading the renal vein. We can conclude that tumor size in CRCC is not a prognostic factor that allows determining postoperative survival independently, and for this reason, it should be considered as a variable that acquires importance when evaluated together with the presence of vascular invasion or adjacent tissues. We can confirm that the Fuhrman Histological Grade is useful as an independent parameter of survival when grouped into low and high grades.