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 is 75% for localized disease, around 50% with regional spreading, and less than 10% with metastasis (Cancer Registry of Norway).
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