Deoxyribonucleic acid (DNA) content was retrospectively determined by single-cell cytophotometry in primary tumors and corresponding metastases from 32 patients with renal cell carcinoma. In 15 of the primary tumors a diploid/near diploid and in 17 an aneuploid DNA content was found. A diploid/near diploid DNA pattern was revealed in 10 metastases and 22 were aneuploid. By comparing the DNA content in the primary tumors with their metastases, 13 of 32 showed a clear divergency, which might illustrate tumor cell heterogeneity of renal cell carcinoma. The DNA pattern showed a close correlation to morphologic grading. A correlation between DNA content in the metastases and survival time was found. Patients, with diploid/near diploid metastases survived significantly longer than those with aneuploid DNA contents (mean, 31.1 and 11.5 months, respectively; P = 0.004). In contrast to this, no correlation was found between DNA content in the primary tumors and survival time.
Cancer 57:2346-2350, 1986.
HE PROGNOSIS for patients with metastasizing renal T cell carcinoma is poor.'" Around one third of the patients with renal cell carcinoma have metastases when diagnosed.3 For these patients a 5-year survival of 5% has been r e p ~r t e d . ~ Of the patients with subsequent metastases, 4870 were diagnosed within 1 year and 70% within 3 years after nephre~tomy.~ A mean survival time of 13 months, after metastatic recurrency, has been reported.2
Recent studies of renal cell carcinoma have indicated a relationship between deoxyribonucleic acid (DNA) content and clinical c o u r ~e . ~* ~ Patients with a diploid/near diploid tumor DNA content have been associated with a better prognosis than patients with aneuploid tumors. However, we have shown that in renal cell carcinoma, a considerable heterogeneity concerning the DNA content exists in primary tumors8
In order to achieve further information on tumor heterogeneity and its possible implications for tumor spread and clinical course, we compared the DNA content in primary tumors and metastases in individual patients.