PROGNOSTIC VALUE OF DEOXYRIBONUCLEIC-ACID CONTENT IN METASTATIC RENAL-CELL CARCINOMA

The deoxyribonucleic acid content of tumor specimens from 23 patients with metastatic renal cell carcinoma was analyzed prospectively by flow cytometry and static cytophotometry. Of the primary tumors 10 (43 per cent) were homogeneously diploid or near diploid in 8 samples studied from each tumor and 13 (57 per cent) had an aneuploid deoxyribonucleic acid content in 1 to 8 samples. At the end of followup 9 of 10 patients with diploid or near diploid primary tumors were alive, compared to only 1 of 13 with aneuploid primary tumors. Patients with homogeneously diploid or near diploid tumors survived significantly longer compared to those with aneuploid tumor deoxyribonucleic acid content (p less than 0.001). After excision of solitary diploid or near diploid metastases 4 patients had no evidence of disease. In 3 of these patients the primary tumors were diploid or near diploid, whereas 1 had 1 aneuploid and 7 diploid or near diploid samples in the primary tumor. In 10 other patients 28 metastases revealed concordance in deoxyribonucleic acid content with the primary tumors. Our results indicate that deoxyribonucleic acid content might be a useful prognostic discriminator with implications for the clinical management of patients with metastatic renal cell carcinoma.