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Determining the prognosis of patients with renal cell carcinoma: is it time for a re-evaluation?

Nature Clinical Practice Urology volume 3, pages 510–511 (2006)Cite this article

More than 40% of patients with renal cell carcinoma (RCC) will die from their cancer, compared with approximately 20% of patients with prostate and bladder cancers.1 Advances in imaging, staging, and surgical techniques, as well as current biologic, immune-based, and molecularly targeted therapies, have resulted in improved survival for patients with both localized and metastatic disease. Nevertheless, a significant number of patients with localized disease relapse despite definitive surgery, and response and survival rates for patients with metastatic RCC remain modest.2 The wide disparity in clinical outcomes for patients with RCC underscores the critical importance of accurate indicators of prognosis for this population.

Surgical staging systems, which stratify patients into categories defined by the size and spread of their tumor, have long been the fundamental tools for defining patient prognosis. In addition to prognostic information, staging systems provide descriptions of tumor characteristics, information to aid in surgical planning, criteria to identify patient populations for specific adjuvant therapies, and inclusion criteria for clinical trials. In 2002, the American Joint Committee on Cancer revised the tumor-node-metastasis (TNM) system proposed by the Union Internationale Contre le Cancer in 1997.3,4 Despite the proven usefulness of this anatomy-based staging system for predicting patient outcomes, nearly every stratification factor of the most recent version of the TNM staging system has been contested and debated in the RCC literature.

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  1. Associate Professor of Urology in the Department of Urology at the Geffen School of Medicine, UCLA, Los Angeles, CA, USA

    John T Leppert & Allan J Pantuck

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  1. John T Leppert
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  2. Allan J Pantuck
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Correspondence to Allan J Pantuck.

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Leppert, J., Pantuck, A. Determining the prognosis of patients with renal cell carcinoma: is it time for a re-evaluation?. Nat Rev Urol 3, 510–511 (2006). https://doi.org/10.1038/ncpuro0598

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