Published in Cancer Detection and Prevention 2000; 24(Supplement 1).

Dna content and survival rates of patients with renal cell carcinoma: a prospective study on 230 cases

H Al-Abadi MD 1, V Borgmann MD 2, I Rotter CTIAC 3, R Nagel MD 4, P Neuhaus MD 5

1 Dept General, Visceral and -Transplantation's Surgery, Div Clinical Cytology and DNA-Cytometry and, 2 Dept Urology, Charitè, Campus Virchow Clinic, Humboldt University, Berlin, Germany, 3 Dept Urology, Clinic, Nauen, Germany,

AIMS: Renal cell carcinoma have a very unfavorable prognosis. The variety of grading systems in use indicate that the search for relevant prognosis parameters is still under way. In the present study the ploidy and DNA heterogeneity of the primary tumor were analyzed by means of image cytometry with the intention of finding prognostic factors in addition to those already known (stage and grade). METHODS: From February 1982 to February 1995 radical nephrectomy and lymphadenectomy were performed in 230 patients with renal cell carcinoma. The follow up period ranged from 5 to 13 years. The quantitative DNA analyses were performed by means of image cytometry using a DNA-cytometer. RESULTS: 8% of the patients were in stage T1N0Mx, 41% were in stage pT2pN0Mx and 51% of them were in stage pT3pN2-4Mx. 43% of the patients had carcinoma grade 1, further 41% grade 2 and 16% showed grade 3 tumors. There was a significant correlation between the results of DNA image cytometry and the clinical course of the disease. Patients with homogeneously diploid tumor cell lines developed no metastases and no local tumor progression during the follow up period of 12 years, whereas patients with heterogeneous aneuploid DNA distribution developed metastases and local tumor progression within 28 months. CONCLUSIONS: DNA cytometry allows better prediction of the prognosis of renal cell carcinoma compared to histopathological staging and grading.

KEY WORDS: Renal cell carcinoma, DNA ploidy, prognosis.

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Paper presented at the International Symposium on Impact of Biotechnology on Cancer Diagnostic & Prognostic Indicators; Geneva, Switzerland; October 28 - 31, 2000; in the section on prognostic markers.