A postoperative prognostic nomogram for renal cell carcinoma

被引:593
|
作者
Kattan, MW
Reuter, V
Motzer, RJ
Katz, J
Russo, P
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Urol, New York, NY 10021 USA
[2] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10021 USA
[3] Mem Sloan Kettering Canc Ctr, Dept Pathol, New York, NY 10021 USA
[4] Mem Sloan Kettering Canc Ctr, Dept Med, Genitourinary Oncol Serv, New York, NY 10021 USA
来源
JOURNAL OF UROLOGY | 2001年 / 166卷 / 01期
关键词
carcinoma; renal cell; neoplasms; abnormalities;
D O I
10.1016/S0022-5347(05)66077-6
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Few published studies have combined prognostic factors to predict the likelihood of recurrence after surgery for renal cell carcinoma. We developed a nomogram for this purpose. Materials and Methods: With Cox proportional hazards regression analysis, we modeled pathological data and disease followup for 601 patients with renal cell carcinoma who were treated with nephrectomy. Predictor variables were patient symptoms, including incidental, local or systemic, histology, including chromophobe, papillary or conventional, tumor size, and pathological stage. Treatment failure was recorded when there was either clinical evidence of disease recurrence or death from disease. Validation was performed with a statistical (bootstrapping) technique. Results: Disease recurrence was noted in 66 of the 601 patients, and those in whom treatment was successful had a median and maximum followup of 40 and 123 months, respectively. The 5-year probability of freedom from failure for the patient cohort was 86% (95% confidence interval 82 to 89). With statistical validation, predictions by the nomogram appeared accurate and discriminating with an area under the receiver operating characteristic curve, that is a comparison of the predicted probability with the actual outcome of 0.74. Conclusions: A nomogram has been developed that can be used to predict the 5-year probability of treatment failure among patients with newly diagnosed renal cell carcinoma. The nomogram may be useful for patient counseling, clinical trial design and patient followup planning.
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页码:63 / 67
页数:5
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