Kidney cancer

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Prognosis and survival for kidney cancer

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

A prognostic factor is an aspect of the cancer or a characteristic that you have 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, and they both play a part in deciding on a treatment plan and a prognosis.

The following are prognostic and predictive factors for kidney cancer.

Stage

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. Kidney cancer that has spread to the large vein in the abdomen leading to the heart (called the vena cava) have a poor prognosis.

Grade

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.

Type of kidney cancer

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

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

Level of risk

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

  • The Karnofsky performance status score is less than 80.
  • There was less than 1 year between treatment and a diagnosis of metastatic cancer.
  • The blood calcium level is abnormally high (which may mean kidney failure).
  • The red blood cell count is lower than normal (called anemia).
  • The platelet count is lower than normal (called thrombocytopenia).
  • 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.

People with metastatic kidney cancer who have a favourable risk level have a better prognosis and survival than people with a poor risk level.

Karnofsky performance status scale

A standard measure of a person’s ability to perform ordinary tasks and carry out daily activities.

The Karnofsky performance status scale is used to assess a person’s prognosis, to monitor changes in a person’s ability to function or decide if a person is suitable for a clinical trial. The person’s performance status is given a score out of 100. The higher the score, the better able a person is to carry out daily activities.

Also called Karnofsky performance scale or Karnofsky scale.

neutrophil

A type of granulocyte (white blood cell) that helps defend the body against bacteria, viruses and types of fungus.

Neutrophils are a type of phagocyte (a white blood cell that surrounds and kills bacteria or micro-organisms, eats foreign material, removes old or damaged cells and helps to boost the immune system).

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