Prognosis and survival for kidney cancer

If you have kidney cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.

A prognostic factor is an aspect of the cancer that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.

The following are prognostic and predictive factors for kidney cancer.

The stage of kidney cancer is the most important prognostic factor. People who have tumours that are only in the kidney have a better prognosis than people with cancer that has spread outside the kidney.

Low-grade tumours have a better prognosis than high-grade tumours. Low-grade tumours are less likely to spread because they grow slowly. High-grade tumours are more aggressive and tend to spread quickly.

Papillary and chromophobe types of renal cell carcinoma have a better prognosis because they are often low grade.

Collecting duct carcinoma and renal medullary carcinoma have a poor prognosis because they are often very aggressive.

The most common system used to predict prognosis for people with metastatic renal cell carcinoma is the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC). It uses 6 predictors:

• The Karnofsky performance status scale is less than 80.
• There was less than 1 year between diagnosis and treatment of metastatic cancer.
• The blood calcium level is abnormally high.
• The red blood cell count is lower than normal (called anemia).
• The platelet count is greater than normal (called thrombocytosis).
• There is an abnormally high level of neutrophils (called neutrophilia).

These predictors are combined to develop a level of risk:

• Favourable risk means the person has none of the predictors.
• Intermediate risk means the person has 1 or 2 predictors.
• Poor risk means the person has 3 or more predictors.