Title: Assessing the Prognostic Significance of Fuhrman Grading in Renal Cell Carcinoma by Comparing with Morphological Prognostic Factors

Authors: Vissa Shanthi M.D, Nandam Mohan Rao, M.D, Byna Syam Sundara Rao, M.D, Bhavana Grandhi, M.D, Muram Reddy Vijaya Lakshmi, M.D

 DOI:  http://dx.doi.org/10.18535/jmscr/v3i10.11

Abstract

Back ground – Renal cell carcinoma is a disease of varying prognosis. We evaluated the prognostic significance of Fuhrman nuclear grade by comparing with various morphological parameters which are considered to be independent prognostic factors in determining the patient outcome.

Materials and methods – Retrospective and prospective study was conducted on patients who underwent nephrectomy during the period of January 2010 to June 2015. 128 cases of nephrectomies were studied out of which 32 cases had renal cell carcinomas which were studied in detail. Fuhrman grade of these tumors were compared with various morphological prognostic factors like tumor subtype the tumor size, tumor multicentricity, presence of sarcomatoid differentiation, necrosis, perinephric fat infiltration, lymph node metastasis, distant metastasis  and vascular invasion by tumor.

Results – Out of 128 cases of nephrectomies, 32 cases had renal cell carcinomas. Male predominance was noted (68.75%) in these cases. Fuhrman grade in these tumors were found to have correlation with prognostic factors like tumor stage,  tumor size, presence of tumor necrosis, perinephric fat infiltration, vascular embolization, lymphnode metastasis. No significant correlation was found between the tumor grade and multicentricity.

Conclusion – Fuhrman nuclear grading is considered to be independent prognostic factor in  renal cell carcinomas which determines the patient outcome.

Keywords: kidney tumors, Fuhrman grade, prognostic factors.

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