Value of Fuhrman's nuclear grade: comparison with other prognostic factorsof renal carcinomas.

Objective : To assess the prognostic value of Fuhrman's nuclear grade and t o compare it to various clinical and histological prognostic factors of ren al carcinomas. Patients and Method: Single-centre retrospective study of 102 patients oper ated for renal tumours between January 1985 and December 1990 (mean follow- up: 8.2 years). Prognostic assessment was studied from survival curves. Results : The prognostic factors most closely correlated with survival were , ii? decreasing order; metastatic invasion, nuclear grade, stage of local extension and lymph node invasion. A significant (p<0.01) survival difference was only observed between Fuhrma n grade 2 and grade 3 tumours. This difference was accentuated (p<0.001) wh en grade I and 2 tumours were compared to grade 3 and 4 tumours. Fuhrman's nuclear grade is independent of the side affected the tumour volu me, its multifocal nature, microscopic venous invasion and metastatic invas ion at the time of diagnosis. Fuhrman's nuclear grade is correlated with invasion of fat, the presence of a contingent of eosinophilic cells, stage of local extension, lymph node i nvasion and the subsequent development of metastases. Conclusion. This study confirms the importance of Fuhrman's nuclear grade a mong the various prognostic factors of renal carcinomas and quantifies its value with respect to other prognostic factors.