RETROSPECTIVE ANALYSIS OF 156 CASES OF METASTATIC RENAL-CELL CARCINOMA - EVALUATION OF PROGNOSTIC FACTORS AND RESPONSE TO DIFFERENT TREATMENTS

Background: Metastatic renal cell carcinoma is a ''capricious'' tumor. Many prognostic factors have been evaluated, treatment is still contr oversial, and results are not coincident. Methods: We reviewed 156 pat ients with metastatic renal cell carcinoma. Survival from the time of diagnosis was the end point of the study. The influence on survival of age, sex, nephrectomy, disease-free interval, performance status, sit e and number of metastases was analyzed. Univariate and multivariate a nalysis were done. Survival according to different therapies was also evaluated. Results: In our study, no nephrectomy, a disease-free inter val < 24 months, > 2 metastatic sites and a performance status > 2 pro ved to be risk factors. According to the number of risk factors, 3 gro ups of patients were identified (low, intermediate and high risk). We observed 3 kinds of responses to treatments: 1) in untreated patients (n = 48), median overall survival was 6 months, and the 24-month survi val rate was 8%; 2) in patients treated with hormone therapy and/or ch emotherapy (n = 73), median overall survival was 73 months, and the 24 -month survival rate was 24%; 3) in patients treated with interferon a nd/or interleukin-2 (n = 35), median overall survival was 16 months an d the 24-month survival rate was 34%. Conclusions: Our results are onl y partially in accordance with those observed by other authors. Risk f actors and treatment must be determined in more defined and selected s tudies.