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Prognosis of kidney cancer

In 2014, there were an estimated 483,225 people living with kidney and renal pelvis cancer in the United States. The earlier kidney and renal pelvis cancer is caught, the better chance a person has of surviving five years after being diagnosed. 64.9% are diagnosed at the local stage and the 5-year survival for localized kidney and renal pelvis cancer is 92.5%. The number of kidney and renal pelvis cancer deaths is highest among people aged 65-74. Death rates have been falling on average 0.9% each year over 2005-2014 (15).

The prognosis is dependent on factors such as the size of the tumor, stage, and histological type/grade.

Classification of factors that affect prognosis:

  • Clinical: includes general health status, local symptoms, cachexia, and anemia.
  • Anatomical: factors identified by TNM staging. Include tumor size, infiltration into the renal veins, caval vein, renal hilum, the relation to the renal capsule and to the renal fascia, invasion of adrenal glands, spreading to lymph nodes, and distant metastases.  
  • Histological: include Fuhrman grading, histological subtype, absence of sarcomatoid characteristics, and microvascular infiltration. 

Fuhrman's grading is based on shape and size of nuclei and nucleoli. Grade 1 tumors have small nuclei, inconspicuous chromatin, and barely visible nucleoli. Grade 4 tumors have large pleomorphic nuclei, rough chromatin, and prominent nucleoli. Spindle-formed tumor cell growth is always graded as 4. Most renal tumors are graded as 2 or 3.  

 

 

Five-year relative survival for patients with kidney cancer (not including renal pelvis), in percent, during the diagnosis period 1974–2013.

Source: Cancer Registry of Norway

 

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