The Use of the American Society of Anesthesiology Classification as a Prognostic Factor in Patients with Renal Cell Carcinoma

Abstract

Objectives: 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. Conclusion: In this series, the ASA classification could be used as a prognostic factor in renal cell carcinoma.