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. 2023 Nov 10;5(2):289-296.
doi: 10.1002/bco2.309. eCollection 2024 Mar.

Scoring system for prediction of overall survival in patients with renal cell carcinoma T3aN0M0

Caio Vinícius Suartz  1   2 , Maurício Dener Cordeiro  2 , Paulo Afonso de Carvalho  2 , Fábio Pescarmona Gallucci  2 , Leopoldo Alves Ribeiro-Filho  2 , Leonardo Cardili  2 , Arjun Sivaraman  3 , François Audenet  1 , José Mauricio Mota  4 , William Carlos Nahas  2
Affiliations

Scoring system for prediction of overall survival in patients with renal cell carcinoma T3aN0M0

Caio Vinícius Suartz et al. BJUI Compass. .

Abstract

Objective: We aim to create a new score to predict postoperative overall survival in patients with nonmetastatic T3aN0 renal cell carcinoma.

Methods: We reviewed the clinical data of adult patients who underwent radical nephrectomy for renal cell carcinoma between December 2007 and January 2022 in a single tertiary oncological institution. Clinical characteristics, clinical-pathological staging and histopathological characteristics were analysed. Survival analyses were determined using the Kaplan-Meier curve. A nomogram was established using Cox proportional hazard regression to identify the prognostic factors affecting the overall survival. The area under the curve, calibration curves and decision curve analysis were used to evaluate prognostic efficacy.

Results: We analyzed 362 patients classified as pT3aN0M0 stage with a median follow-up of 40 months. According to Cox univariate and multivariate analyses, weight loss greater than 5% in 6 months before surgery, stage V chronic kidney disease after radical nephrectomy, sarcomatoid pattern, and coagulative tumor necrosis were identified as predictors of overall survival. We developed a score and performed internal and external validation. The time-dependent receiver operating characteristic curve, area under the curve value and calibration curve analysis showed good prediction ability of the score. The nomogram can effectively predict and stratify overall survival after radical nephrectomy in patients with pT3aN0M0 renal cell carcinoma.

Conclusion: Patients with pT3aN0MO renal cell carcinoma exhibited different characteristics, and those with unfavourable characteristics deserve greater attention during follow-up. This nomogram provides an accurate prediction of overall survival after radical nephrectomy.

Keywords: adjuvant therapy; kidney neoplasms; oncologic outcome; prognostic factor; renal cell carcinoma.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
CONSORT flow diagram showing patient exclusions.
FIGURE 2
FIGURE 2
The Kaplan–Meier curve analysis for overall survival by sarcomatoid differentiation.
FIGURE 3
FIGURE 3
The Kaplan–Meier curve analysis for overall survival by coagulative tumour necrosis.
FIGURE 4
FIGURE 4
Nomogram to predict overall survival in T3aN0 renal cell carcinoma.
FIGURE 5
FIGURE 5
The receiver operating characteristic curve and area under the curve value (A) and calibration plot (B) of the nomogram for predicting 5‐year overall survival (OS) in the training cohort.
FIGURE 6
FIGURE 6
Score to predict overall survival in 5 years for patients with renal cell carcinoma (RCC) T3aN0 and Kaplan–Meier curve analysis with log‐rank test (A). Stratified score into three categories with logrank test (B).
See this image and copyright information in PMC

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