PROGNOSTIC VALUE OF FUHRMANS GRADE IN REN AL-CELL CARCINOMA - A STUDYOF 170 CASES

In order to evaluate the prognostic value of the anatomical stage (pTN M 1992) and of the histological factors (Fuhrman's grade, cellular and architectural types), 170 renal cell carcinoma diagnosed between 1971 and 1991 were reviewed.In univariate analysis, the prognosis was corr elated with the anatomical stage and Fuhrman's grade: for the 125 pati ents without metastasis, grades 1 and 2 had a good prognosis, whereas grades 3 and 4 did poorly. The cellular type was not related to surviv al. Among architectural types, only the pseudo-sarcomatous type was co rrelated with prognosis. Multivariate analysis revealed that grade and metastasis at diagnosis were two independent predictors of survival; the grade was prognostically superior to metastasis. Fuhrman's grade i s essential in determining prognosis; its statistical value is superio r to anatomical stage in multivariate analysis.