A COMPARISON BETWEEN HISTOLOGICAL GRADE AND NUCLEAR MORPHOMETRY FOR PREDICTING THE CLINICAL OUTCOME OF LOCALIZED RENAL-CELL CARCINOMA

Objectives To determine the interrelationship of histological grade an d nuclear morphometry and to compare their prognostic significance in patients with localized renal cell carcinoma (RCC). Patients and metho ds A retrospective prognostic study of 39 patients with localized (pT1 , pT2) RCC was performed, Conventional histological grade and nuclear morphometry were assessed independently and the correlation between th ese grading systems and their impact on the patients' outcome were eva luated. Results Histological grade and the nuclear morphometric variab les were significantly correlated; the strongest association was that between grade and the nuclear regularity factor. The best predictor of disease-free interval and survival (by univariate analysis) was the c ombination of nuclear area and nuclear elongation factor, followed by conventional tumour grade, nuclear elongation factor, nuclear regulari ty factor and nuclear area. However, a multivariate analysis showed th at the only independent prognosticator for survival was the combinatio n of nuclear area and nuclear elongation factor. Conclusions This stud y indicates that nuclear morphometry is prognostically superior to his tological grade in patients with localized RCC.