p53 mutations and other prognostic factors of renal cell carcinoma

Objective: Tumor stage, histological pattern, cell type, diameter and cell ploidy are the factor that have been proposed for predicting the prognosis of renal cell carcinoma (RCC). There isa wide variation in the reported inc idence of p53 mutation in RCC, and its prognostic significance for this tum or is unknown. We investigated the prognostic value of p53 mutations among other prognostic factors. Patients and Method: We evaluated the stages, tum or diameters, histological grades, cellular patterns and the presence of mu tant p53 protein in 50 cases of RCC. The survival function of each paramete r was estimated by Kaplan-Meier and log-rank tests, and the significance of each para meter on survival was evaluated by logistic regression analysis. Results: The p53 mutation incidence was 20% in the RCC cases included in t he study (n = 50). The survival rates of stages pT(2), pT(3) and pT(2-3)Nwere 87.8, 61.0 and 0%, respectively (p = 0.0462). The survival analysis of grade 1-2 and grade 3-4 tumors revealed 92.3 and 51.5% survival rates, res pectively (p = 0.002). The survival rates of mutant p53+ and mutant p53- ca ses were 33.3 and 84.2%, respectively (p = 0.0027). The logistic regression test analysis demon strated that tumor grade, tumor stage and mutant p53 p ositivity status were the most significant prognostic factors (p < 0.03). T he survival rates of mutant p53+ and p53- cases at stages pT(2), pT(3) and PT2-3N+ were 66.67 versus 91.48%, 33.3 versus 71.43% and 0 versus 100%, res pectively(p = 0.0392). A similar finding was present at each stage for cell ular grades (p = 0.0093). The survival rates of mutant p53+ and p53- cases for grades 3 and 4 were 33.33 and 74.48%, respectively (p = 0.2731). Conclu sion: Our results suggested that many parameters can affect survial of RCC cases, but among these, tumor grade, tumor stage and p53 mutation status ar e the most important prognostic factors, but p53 mutation status and cellul ar grade can afford additional prognostic information at each stage. Copyri ght (C) 2001 S. Karger AG,Basel.