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

140 Citations (Scopus)

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
Pages (from-to)1759-1763
Number of pages5
JournalJournal of Urology
Volume174
Issue number5
DOIs
StatePublished - Nov 1 2005
Externally publishedYes

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Nephrectomy
Clinical Trials
Renal Cell Carcinoma
Survival
Neoplasm Metastasis
Neoplasms
Proportional Hazards Models
Clear-cell metastatic renal cell carcinoma
Thrombosis
Necrosis
Survival Rate
Bone and Bones
Liver

Keywords

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

ASJC Scopus subject areas

  • Urology

Cite this

A scoring algorithm to predict survival for patients with metastatic clear cell renal cell carcinoma : A stratification tool for prospective clinical trials. / Leibovich, Bradley C.; Cheville, John C.; Lohse, Christine M.; Zincke, Horst; Frank, Igor; Kwon, Eugene D.; Merchan, Jaime R; Blute, Michael L.

In: Journal of Urology, Vol. 174, No. 5, 01.11.2005, p. 1759-1763.

Research output: Contribution to journalArticle

Leibovich, Bradley C. ; Cheville, John C. ; Lohse, Christine M. ; Zincke, Horst ; Frank, Igor ; Kwon, Eugene D. ; Merchan, Jaime R ; Blute, Michael L. / A scoring algorithm to predict survival for patients with metastatic clear cell renal cell carcinoma : A stratification tool for prospective clinical trials. In: Journal of Urology. 2005 ; Vol. 174, No. 5. pp. 1759-1763.
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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.",
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T1 - A scoring algorithm to predict survival for patients with metastatic clear cell renal cell carcinoma

T2 - A stratification tool for prospective clinical trials

AU - Leibovich, Bradley C.

AU - Cheville, John C.

AU - Lohse, Christine M.

AU - Zincke, Horst

AU - Frank, Igor

AU - Kwon, Eugene D.

AU - Merchan, Jaime R

AU - Blute, Michael L.

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N2 - 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.

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