A postoperative prognostic nomogram for renal cell carcinoma Journal Article


Authors: Kattan, M. W.; Reuter, V.; Motzer, R. J.; Katz, J.; Russo, P.
Article Title: A postoperative prognostic nomogram for renal cell carcinoma
Abstract: 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.
Keywords: adult; treatment outcome; aged; survival rate; treatment failure; major clinical study; cancer recurrence; validation process; cancer staging; follow-up studies; neoplasm staging; sensitivity and specificity; neoplasms; reproducibility of results; neoplasm recurrence, local; tumor volume; proportional hazards models; incidence; cohort analysis; risk factors; kidney carcinoma; kidney neoplasms; nephrectomy; carcinoma, renal cell; probability; models, statistical; carcinoma; predictive value of tests; regression analysis; roc curve; receiver operating characteristic; renal cell; abnormalities; humans; prognosis; human; male; female; priority journal; article
Journal Title: Journal of Urology
Volume: 166
Issue: 1
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2001-07-01
Start Page: 63
End Page: 67
Language: English
PUBMED: 11435824
PROVIDER: scopus
DOI: 10.1016/S0022-5347(05)66077-6
DOI/URL:
Notes: Export Date: 21 May 2015 -- Source: Scopus
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MSK Authors
  1. Paul Russo
    582 Russo
  2. Robert Motzer
    1247 Motzer
  3. Victor Reuter
    1229 Reuter
  4. Michael W Kattan
    218 Kattan
  5. Jared   Katz
    13 Katz