ABSTRACT
OBJECTIVE: To assess the prognostic value of Führman's nuclear grade and to compare it to various clinical and histological prognostic factors of renal carcinomas. PATIENTS AND METHOD: Single-centre retrospective study of 102 patients operated for renal tumours between January 1985 and December 1990 (mean follow-up: 8.2 years). Prognostic assessment was studied from survival curves. RESULTS: The prognostic factors most closely correlated with survival were, in decreasing order, metastatic invasion, nuclear grade, stage of local extension and lymph node invasion. A significant (p < 0.01) survival difference was only observed between Führman grade 2 and grade 3 tumours. This difference was accentuated (p < 0.001) when grade 1 and 2 tumours were compared to grade 3 and 4 tumours. Führman's nuclear grade is independent of the side affected, the tumour volume, its multifocal nature, microscopic venous invasion and metastatic invasion at the time of diagnosis. Führman's nuclear grade is correlated with invasion of fat, the presence of a contingent of eosinophilic cells, stage of local extension, lymph node invasion and the subsequent development of metastases. CONCLUSION: This study confirms the importance of Führman's nuclear grade among the various prognostic factors of renal carcinomas and quantifies its value with respect to other prognostic factors.
