[Nuclear area versus nuclear grade in the prognosis of renal carcinoma. Long-term results].

Fürhman's nuclear grading was used to compare the prognostic value of nuclear morphometry (represented by the nuclear area) in 95 renal adenocarcinomas treated by radical nephrectomy with a 11 to 25 years follow-up. The morphometric study was conducted by measuring 100 randomly selected nuclei, with a x1000 MOP-Videoplan morphometer and a light chamber adapted to a microscope. Based on the nuclear area, 2 prognostic groups were made up, one for area values below 35 microns2 and another one for areas over 35 microns2. The nuclear grade was reassigned in all cases according to Fürhman's rating, assembling G1-2s as low grade and G3-4s as high grade for statistical convenience. Staging was done using Tonson's classification; stage II was divided into III-A (venous involvement) and III B + C (presence of adenopathy). The survival analysis was included in the sample overall analysis and in each stage. Survival showed significant differences between groups with areas over and below 35, and between high and low grade. Only 2 cases in stage III B + C and none in stage IV had areas below 35. When comparing survival between under 35 and low grade cases, and between over 35 and high grade cases, no significant difference was obtained. It was therefore conclude that, although nuclear morphometry is a good prognostic factor in renal carcinoma, it contributes little to nuclear grading and it has the drawback of being too elaborate.