Increased serum cortisol levels are associated with high tumour grade in patients with renal cell carcinoma

Cortisol and dehydroepiandrosterone (DHEA) and its sulphate (DHEAS) are the major steroid hormones produced by the human adrenal cortex. The serum lev els of cortisol and DHEAS were analysed in 211 consecutive patients with re nal cell carcinoma before initiation of therapy. Serum cortisol was signifi cantly higher in patients with renal cell carcinoma compared with that in p atients with benign cysts (p < 0.0001). Serum cortisol was independent of d isease stage, but positively correlated to tumour diameter and grade. The s erum levels of DHEAS were higher in men than in women, and decreased with a ge but did not correlate with disease stage, tumour diameter or grade. The prognosis of patients with elevated serum cortisol tended to be poorer (p = 0.06) than the prognosis of those with lower levels. In a multivariate ana lysis, disease stage and tumour grade were independent predictors of progno sis. Age, gender and serum levels of cortisol and DHEAS were of limited val ue for prognosis.