VALUE OF TUMOR SIZE IN PREDICTING SURVIVAL FROM RENAL-CELL CARCINOMA AMONG TUMORS, NODES AND METASTASES STAGE-1 AND STAGE-2 PATIENTS

Results in the literature are inconsistent regarding the value of tumo r size in predicting survival from renal cell carcinoma, and its use a s a staging variable in the current tumors, nodes and metastases syste m has been questioned. In this study tumor size had no prognostic sign ificance in Kaplan-Meier or Cox regression models examining survival d ifferences between 93 patients with stage T1N0M0 and T2N0M0 renal cell carcinoma dichotomized by tumor size cutoffs at 2.5, 5, 7.5 or 10 cm. In multivariate Cox regression models for 122 patients with stage T1N allMall or T2MallMall renal cell carcinoma, metastatic disease was the strongest predictor of survival, and patients with smaller tumors had significantly longer survival than those with larger tumors at all cu toffs except 2.5 cm., for which differences were insignificant. A 5 cm . cutoff maximized the value of tumor size in predicting survival. If tumor size is to remain the variable by which tumors, nodes and metast ases stages T1 and T2 disease are differentiated, a 5 cm. cutoff shoul d replace the current 2.5 cm. definition.