LOCALIZED RENAL-CELL CARCINOMA TREATED BY RADICAL NEPHRECTOMY - INFLUENCE OF PATHOLOGICAL DATA AND THE IMPORTANCE OF DNA-PLOIDY PATTERN ON DISEASE OUTCOME

Background. The course of patients with renal cell carcinoma may be co nsiderably different. Approximately 50% with presumed localized diseas e have metastases after nephrectomy. Pathologic stage at diagnosis, hi stologic grade, and histologic type have been considered the most impo rtant predictors of prognosis. Nevertheless, subsets of patients withi n a specified stage and grade may have considerable differences in dis ease progression and survival. Methods. Flow cytometric nuclear DNA an alysis was used to study pathologic Stage I or II renal cell carcinoma in 54 patients who underwent radical nephrectomy between 1974 and 198 3. Results. Sixty-three percent of the tumors were diploid, and 37% an euploid. A DNA diploid pattern was more common among Stage I tumors th an Stage II tumors (69% versus 33%; P < 0.04). Progression occurred in 31% of the diploid tumors, whereas among the aneuploid group the prog ression rate reached 59% (P < 0.06). Considered as a single indicator, DNA ploidy pattern was strongly associated with patient survival. Ten years after surgery 79% of the patients who had diploid tumors and 50 % of those with aneuploid tumors were alive (P < 0.02). Conclusions. N uclear DNA ploidy may serve as an important prognostic variable for pa tients with early stage renal cell carcinoma.