PREOPERATIVELY DETERMINED PROGNOSTIC FACTORS IN METASTATIC RENAL-CELLCARCINOMA

Objectives: The aim of this study was to clarify the pre-operatively d etermined factors affecting the prognosis in patients with metastatic renal cell carcinoma (RCC). Methods: We analyzed 69 patients with meta static RCC who received nephrectomy. Multivariate analysis by Cox's pr oportional hazards model and survival studies were applied. Results: T umor thrombus in a renal vein or vena cava was the most significant po or-prognostic factor, followed by multiple-organ metastases and three or more abnormal findings of factors related to acute-phase proteins, in this order. Seven patients having these three risk factors died of cancer within 7 months after nephrectomy. On the other hand, half of t he patients without risk factors survived for more than 2 years. Concl usions: Risk status should be used for selection of metastatic-RCC pat ients for treatment of the primary site.