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.
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.
Authors: Andrew Feifer; Caroline Savage; Heidi Rayala; William Lowrance; Geoffrey Gotto; Preston Sprenkle; Amit Gupta; Jennifer Taylor; Melanie Bernstein; Adebowale Adeniran; Satish K Tickoo; Victor E Reuter; Paul Russo Journal: J Urol Date: 2010-11-12 Impact factor: 7.450
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Authors: Alexander S Parker; Bradley C Leibovich; Christine M Lohse; Yuri Sheinin; Susan M Kuntz; Jeanette E Eckel-Passow; Michael L Blute; Eugene D Kwon Journal: Cancer Date: 2009-05-15 Impact factor: 6.860
Authors: Thomas Steiner; Hartmut Kirchner; Michael Siebels; Christian Doehn; Hans Heynemann; Zoltan Varga; Detlef Rohde; Joerg Schubert; Dieter Jocham; Christian Stief; Paolo Fornara; Rainer Hofmann; Stefan Loening; Jan Roigas Journal: J Cancer Res Clin Oncol Date: 2009-12-12 Impact factor: 4.553