Klin Onkol 2005; 18(6): 216-218.
Summary: Identification and evaluation of prognostic factors significantly influences the treatment results in metastatic renal cell cancer patients. It was the relationship between pre-treatment prognostic factors and the survival rate that was the aim of our study.
Patients and methods: 33 metastatic renal cell cancer patients treated with immunochemotherapy according to Atzpodien during the period between 1996 2004 were included in the study. The following prognostic risk factors associated with lower survival rate were studied:
- Karnofsky performance status lower than 80 %
- lactate dehydrogenase levels >1,5x of the upper limit of normal
- serum hemoglobin < lower limit of normal
- serum calcium above normal
- absence of previous nephrectomy.
Results: Favorablerisk group (zero risk factors) included 18 patients (55%), reaching a median survival time of 21,3 months (5-133 months). Intermediate-risk group (one or two risk factors) included 15 patients (45%) with a median survival time of 10,9 months (2-114 months). No patients with three and more risk factors were found and included in the study. Median follow-up time was 32 months (4-114 months).
Conclusion: Our study confirmed the relationship between risk prognostic factors and a lower chance of survival. It is reasonable to categorize patients into risk groups as it helps in the prognosis assessment and in designing of new clinical trials. However, whether and how the prognostic factors should influence the current treatment approach remains a question.
