Prognostic score for patients with localized renal cell carcinoma treated by nephrectomy

Objective: To evaluate the feasibility of using combined clinical and histo morphometric features to construct a prognostic score for the individual pa tient with localized renal cell carcinoma. Patients and Methods: We studied 39 patients with pT1 and pT2 RCC who under went radical nephrectomy between 1974 and 1983. Univariate and multivariate analyses were used to determine the association between various prognostic features and patient survival. Results: The most important and independent predictors of survival were tum or angiogenesis (P = 0.009), nuclear DNA ploidy (P = 0.0071), mean nuclear area (P = 0.013), and mean elongation factor (P = 0.0346). Combination of t hese variables enabled prediction of outcome for the individual patient at a sensitivity and specificity of 78% and 89%, respectively. Conclusion: Our results indicate that no single parameter can accurately pr edict the outcome for patients with localized RCC. Combination of neovascul arity, DNA content and morphometric shape descriptors enabled a more precis e stratification of the patients into different risk categories.