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Vol. 41. Issue 4.
Pages 215-225 (May 2017)
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Vol. 41. Issue 4.
Pages 215-225 (May 2017)
Review article
Systematic review of renal carcinoma prognostic factors
Revisión sistemática de los factores pronósticos del carcinoma renal
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D. Lorentea, E. Trillaa,
Corresponding author
enriquetrilla@gmail.com

Corresponding author.
, A. Meseguerb, J. Planasa, J. Placera, A. Celmaa, C. Salvadora, L. Regisa, J. Morotea
a Servicio de Urología, Hospital de la Vall d’Hebron, Universidad Autonoma de Barcelona, Barcelona, Spain
b Unidad de fisiología y fisiopatología renal (VHIR), Barcelona, Spain
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Tables (4)
Table 1. Clinical prognostic factors.
Table 2. Pathological prognostic factors.
Table 3. Biological prognostic factors.
Table 4. Molecular prognostic factors.
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Abstract
Context and objectives

The natural history of renal cell carcinoma is heterogeneous. Some scenarios can be found in terms of clinical presentation, clinical evolution or type of recurrence (local/metastatic). The aim of this publication is to analyze the most important prognostic factors published in the literature.

Evidence acquisition

A literature review ob published papers was performed using the Pubmed, from first Motzer's classification published in 1999–2015, according to PRISMA declaration. Search was done using the following keywords: kidney neoplasm, kidney cancer, renal cell carcinoma, prognostic factors, mortality, survival and disease progression. Papers were classified according to level of evidence, the number of patients included and the type of study performed.

Evidence synthesis

The evolution in the knowledge of molecular pathways related to renal oncogenesis and the new targeted therapies has left to remain obsolete the old prognostic models. It is necessary to perform a continuous review to actualize nomograms and to adapt them to the new scenarios.

Conclusions

Is necessary to perform a proper external validation of existing prognostic factors using prospective and multicentric studies to add them into the daily urologist clinical practice.

Keywords:
Renal cell carcinoma
Nomogram
Prognostic factors
Resumen
Contexto y objetivo

La evolución natural del carcinoma renal es heterogénea, encontrando diversos escenarios en cuanto a la presentación clínica, evolución y tipo de recidiva (local/metastásica). El objetivo de esta publicación es revisar la literatura existente con relación a los principales factores pronósticos del carcinoma renal.

Adquisición de evidencia

Se realiza una revisión sistemática mediante Pubmed de los artículos publicados, de acuerdo con los principios de la declaración PRISMA, desde 1999 (primera publicación de la clasificación de Motzer) hasta 2015. Los términos utilizados en la búsqueda han sido «kidney neoplasms», «kidney cancer», «renal cell carcinoma», «prognostic factors», «mortality», «survival» y «disease progression».

Síntesis de evidencia

El mejor conocimiento de las vías moleculares implicadas en la oncogénesis renal junto con la aparición de tratamientos dirigidos con nuevas moléculas están provocando que los antiguos modelos pronósticos queden obsoletos, requiriendo de una revisión continua para la actualización de los nomogramas disponibles adaptados a los nuevos escenarios.

Conclusiones

Es importante una correcta validación externa de los factores pronósticos existentes mediante estudios prospectivos y multicéntricos, para poder así incorporarlos a la práctica clínica habitual del urólogo.

Palabras clave:
Carcinoma renal
Nomograma
Factores pronósticos

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