Pre-operatively determined prognostic factors in metastatic renal cell carcinoma

Objectives: The aim of this study was to clarify the pre-operatively determined factors affecting the prognosis in patients with metastatic renal cell carcinoma (RCC). Methods: We analyzed 69 patients with metastatic RCC who received nephrectomy. Multivariate analysis by Cox's proportional hazards model and survival studies were applied. Results: Tumor thrombus in a renal vein or vena cava was the most significant poor-prognostic factor, followed by multiple-organ metastases and three or more abnormal findings of factors related to acute-phase proteins, in this order. Seven patients having these three risk factors died of cancer within 7 months after nephrectomy. On the other hand, half of the patients without risk factors survived for more than 2 years. Conclusions: Risk status should be used for selection of metastatic-RCC patients for treatment of the primary site.