Weipu Mao1, Zhenrui Fu2, Keyi Wang3, Jianping Wu2, Bin Xu4, Ming Chen5. 1. Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China; Surgical Research Center, Institute of Urology, Southeast University Medical School, Nanjing, China; Department of Urology, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China. 2. Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China. 3. Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China. 4. Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China; Surgical Research Center, Institute of Urology, Southeast University Medical School, Nanjing, China; Department of Urology, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China. njxb1982@126.com. 5. Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China; Surgical Research Center, Institute of Urology, Southeast University Medical School, Nanjing, China; Department of Urology, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China. mingchenseu@126.com.
Abstract
BACKGROUND: Our study aimed to establish a clinically practical and reliable prognostic nomogram based on the important prognostic factors to predict the prognosis of patients with lung metastatic renal cell carcinoma (RCC). METHODS: Clinical data of patients with lung metastatic RCC between 2010 and 2015 were collected from the SEER database. Prognostic nomogram was established using R software to predict the OS and CSS probability for individual patients. Consistency index (C-index), calibration curve and decision curve analysis (DCA) were used to assess the predictive performance of the nomogram, and to calibrated the nomogram for 1-, 2-, and 3-year cancer-specific survival (CSS) and overall survival (OS). RESULTS:1,563 patients were enrolled in this study. All patients were randomly divided into the primary cohort (937) and the validation cohort (626). Multivariate Cox regression showed that age, histology, N-stage, T-stage, surgery and radiotherapy were independent risk factor of OS, and histology, N-stage, T-stage, surgery were CSS related factors in patients with lung metastatic RCC in the primary cohort. The C-index of the nomogram OS was 0.662 and the C-index of CSS was 0.658 in the primary cohort. In the validation cohort, the C-index of the nomogram CSS and OS were 0.685 and 0.694, respectively. Moreover, the calibration curves showed good consistency between nomogram predictions and actual 1-, 2-, and 3-year OS and CSS rates in the primary and external verification cohorts. CONCLUSIONS: The prognostic nomogram constructed in this study can provide an individualized treatment and risk assessment for survival in patients with lung metastatic RCC.
RCT Entities:
BACKGROUND: Our study aimed to establish a clinically practical and reliable prognostic nomogram based on the important prognostic factors to predict the prognosis of patients with lung metastatic renal cell carcinoma (RCC). METHODS: Clinical data of patients with lung metastatic RCC between 2010 and 2015 were collected from the SEER database. Prognostic nomogram was established using R software to predict the OS and CSS probability for individual patients. Consistency index (C-index), calibration curve and decision curve analysis (DCA) were used to assess the predictive performance of the nomogram, and to calibrated the nomogram for 1-, 2-, and 3-year cancer-specific survival (CSS) and overall survival (OS). RESULTS: 1,563 patients were enrolled in this study. All patients were randomly divided into the primary cohort (937) and the validation cohort (626). Multivariate Cox regression showed that age, histology, N-stage, T-stage, surgery and radiotherapy were independent risk factor of OS, and histology, N-stage, T-stage, surgery were CSS related factors in patients with lung metastatic RCC in the primary cohort. The C-index of the nomogram OS was 0.662 and the C-index of CSS was 0.658 in the primary cohort. In the validation cohort, the C-index of the nomogram CSS and OS were 0.685 and 0.694, respectively. Moreover, the calibration curves showed good consistency between nomogram predictions and actual 1-, 2-, and 3-year OS and CSS rates in the primary and external verification cohorts. CONCLUSIONS: The prognostic nomogram constructed in this study can provide an individualized treatment and risk assessment for survival in patients with lung metastatic RCC.