[A critical study of the prognosis of renal adenocarcinoma and an attempted classification. Apropos of a series of 322 cases].

The prognosis of adult renal adenocarcinoma was evaluated by analyzing 322 cases treated by extensive nephrectomy (1979-1988). Five-year actuarial survival curves showed that prognosis was closely correlated with anatomic spread: no clear prognostic significance could be ascribed to venous invasion but involvement of retroperitoneal lymph nodes proved to be nearly as negative a prognostic factor as metastatic disease. The grade of malignancy also had a major impact on prognosis. Because the TNM classification, although accurate, is difficult to use and relies solely on descriptive data, a simple five-stage classification is proposed but remains to be validated. The classification system advocated by Robson groups stages with very different outcomes and consequently seems unhelpful.