Author(s): Patard JJ, Leray E, Rodriguez A, RiouxLeclercq N, Guill F,
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Abstract OBJECTIVES: To compare renal tumors with respect to initial clinical presentation and assess the prognostic value of a symptom based classification. MATERIAL AND METHODS: Based on symptoms at diagnosis, 388 renal tumors were stratified into three groups: (1) asymptomatic tumors; (2) tumors with local symptoms (3) tumors with systemic symptoms. The three groups were compared for usual clinical and pathological variables using chi(2)-tests and Anova regression, for qualitative and quantitative variables, respectively. Survival assessment was made with univariate and multivariate analysis using the Kaplan-Meier method and Cox regression analysis. RESULTS: The three defined groups were significantly different for all analysed variables except for age, sex ratio and pathological subtype. In univariate analysis: ECOG performance status, symptom classification, tumour size, TNM stage and grade, adrenal, perinephric fat or vein invasion were significant prognostic factors (p<0.001). In multivariate analysis, symptom classification, TNM stage, Fuhrman grade and perinephric fat invasion remained independent prognostic factors (p<0.001). CONCLUSION: The proposed classification merits further validation through multi-institutional studies before integrating it in further prognosis algorithms.
This article was published in Eur Urol
and referenced in Journal of Clinical Case Reports