Prognostic significance of the pre-operative symptoms in patients after radical nephrectomy for treating localized renal cell carcinoma

Purpose: We investigated the relationship of the pre-operative symptoms to the other clinicopathologic factors that are known to be significant prognostic indicators for patients with renal cell carcinoma. Materials and Methods: Of the 398 patients who underwent an operation for renal cell carcinoma between March 1998 and May 2004, we retrospectively reviewed the clinical records of the 293 who were diagnosed and operated on for localized renal cell carcinoma. The patients were divided into three groups according to their pre-operative clinical symptoms. We then evaluated the patients' characteristics, the pathological factors such as the cell type, tumor size, nuclear grade, the pathological T stage, tumor necrosis, the presence of a sarcomatoid component and multifocality by using ANOVA analysis. The overall survival was estimated using the Kaplan-Meier method and the log-rank test. Results: Of the 293 cases, 118 (40.3%) were in the symptomatic group and 15 (59.7%) were in the asymptomatic groups. There was significant difference in the age, tumor size, the pathological T stage and tumor necrosis between the groups. There was a significant difference in the survival rates between the groups (p < 0.001). Conclusions: Preoperative symptoms are important prognostic factors for patients with localized renal cell carcinoma. Therefore, determining the more specified symptoms is required for separating the groups with different survival after radical nephrectomy.