[Prognosis factors in adenocarcinoma of the kidney. II. Microscopic factors]

The prognostic value of several microscopic parameters were evaluated in 95 cases of renal adenocarcinoma (32 stage I, 18 II, 26 III and 19 IV) submitted to radical nephrectomy and hilar lymphadenectomy with a 5-year follow-up. No prognostic significance was observed for cell type, architectural pattern, borders, and degree of peritumoral lymphocyte infiltration. A worse prognosis was observed for the high (G 3 + 4) in comparison with the low (G 1 + 2) nuclear grade (p less than 0.01). However, analysis according to stage revealed this parameter only affected prognosis in those cases pertaining to intermediate stages II and III. The mean proliferation rate was 2.97 mitoses/10 fields (500 x). A worse prognosis was observed for a proliferation rate greater than 5 mitoses/10 fields (500 x) in comparison to those with a lower rate (p less than 0.01) but evolves parallel to stage.