A scoring algorithm to predict survival for patients with metastatic clear cell renal cell carcinoma: A stratification tool for prospective clinical trials

Bradley C. Leibovich, John C. Cheville, Christine M. Lohse, Horst Zincke, Igor Frank, Eugene D. Kwon, Jaime R. Merchan, Michael L. Blute

Research output: Contribution to journalArticle

145 Scopus citations

Abstract

Purpose: We developed a clinically useful scoring algorithm to predict cancer specific survival for patients with clear cell metastatic renal cell carcinoma (RCC). Materials and Methods: We studied 727 patients treated with radical nephrectomy for clear cell RCC from 1970 to 2000 who had distant metastases at nephrectomy (285) or in whom metastases subsequently developed (442). A scoring algorithm to predict cancer specific survival was developed using the regression coefficients from a Cox proportional hazards model. Results: There were 606 deaths from clear cell RCC at a median of 1.0 years (range 0 to 14) following metastatic RCC. Constitutional symptoms at nephrectomy (+2), metastases to the bone (+2) or liver (+4), metastases in multiple simultaneous sites (+2), metastases at nephrectomy (+1) or within 2 years of nephrectomy (+3), complete resection of all metastatic sites (-5), tumor thrombus level I to IV (+3), and the primary pathological features of nuclear grade 4 (+3) and histological tumor necrosis (+2) were significantly associated with death from RCC. All patients started with a score of 0 and points were added or subtracted as indicated in parentheses. Cancer specific survival rates at 1 year were 85.1%, 72.1%, 58.8%, 39.0%, and 25.1%, respectively, for patients with scores of -5 to -1, scores of 0 to 2, scores of 3 to 6, scores of 7 or 8, and scores of 9 or more. Conclusions: This scoring algorithm can be used to predict cancer specific survival for patients with metastatic clear cell RCC.

Original languageEnglish (US)
Pages (from-to)1759-1763
Number of pages5
JournalJournal of Urology
Volume174
Issue number5
DOIs
StatePublished - Nov 2005
Externally publishedYes

Keywords

  • Carcinoma, renal cell
  • Kidney neoplasms
  • Neoplasm metastasis, survival

ASJC Scopus subject areas

  • Urology

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