[Clinical and pathological characteristics of carcinoma of the kidney: computerized analysis]

To evaluate the significance of the clinical and pathological features and survivorship data, we analyzed 203 cases of renal carcinoma who underwent surgery at our department from 1974 to 1988. Tumor stages P2 and P3 and grades G2 and G3 were the most frequent. The series is large enough to permit classification according to tumor stage and grade and most of the possible associations. The diagnostic procedure and the surgical technique were consistent. Radical nephrectomy via the transperitoneal approach was performed in 153 patients. Transpleural thoracophrenolaparotomy was performed in 22 patients with a very large tumor mass in the upper pole. Extended classical nephrectomy via the lumbar approach was performed in 27 patients. Computer-assisted analysis of the clinical and pathological data showed tumor stage to be an important prognostic factor. Given a similar situation for tumor stage, the histologic grade has been shown to influence prognosis significantly. Other clinical or pathological parameters such as pseudocapsule, histological type and paraneoplastic biological and humoral changes often correlated with tumor stage or grade. Clinical staging is a point of reference for surgery. However, detection of microfoci of tumor metastasis that might be responsible for late reactivation of the disease is as yet not possible.