The Modified International Metastatic Renal Cell Carcinoma Dataset Consortium model (mIMDC) is a preoperative prognostic model for pT3cN0M0 renal cell carcinoma (RCC). This study aimed to validate the mIMDC and to construct a new model in a localized and locally advanced RCC (LLRCC).
A database was established (the Michinoku Japan Urological Cancer Study Group database) consisting of 79 patients who were clinically diagnosed with LLRCC (cT3b/c/4NanyM0) and underwent radical nephrectomy from December 2007 to May 2018. Using univariable and multivariable analyses, we retrospectively analyzed disease-free survival (DFS) and overall survival (OS) in this database, constructed a new prognostic model according to these results, and estimated the model fit using c-index on the new and mIMDC models.
Independent poorer prognostic factors for both DFS and OS include the following: ≥ 1 Eastern Cooperative Oncology Group performance status, 2.0 mg/dL C-reactive protein, and > upper normal limit of white blood cell count. The median DFS in the favorable (no factor), intermediate (one factor), and poor-risk group (two or three factors) was 76.1, 14.3, and 4.0 months, respectively (P < 0.001). The 3-year OS in the favorable, intermediate, and poor-risk group were 92%, 44%, and 0%, respectively (P < 0.001). The c-indices of the new and mIMDC models were 0.67 and 0.60 for DFS (P = 0.060) and 0.74 and 0.63 for OS (P = 0.012), respectively.
The new preoperative prognostic model in LLRCC can be used in patient care and clinical trials.
International journal of clinical oncology. 2023 Sep 22 [Epub ahead of print]
Shigemitsu Horie, Sei Naito, Shingo Hatakeyama, Shuya Kandori, Kazuyuki Numakura, Renpei Kato, Tomoyuki Koguchi, Shingo Myoen, Yoshihide Kawasaki, Akihiro Ito, Hisanobu Adachi, Yoshiyuki Kojima, Wataru Obara, Tomonori Habuchi, Hiroyuki Nishiyama, Chikara Ohyama, Norihiko Tsuchiya
Department of Urology, Faculty of Medicine, Yamagata University, Iida-Nishi 2-2-2, Yamagata, 990-9585, Japan., Department of Urology, Faculty of Medicine, Yamagata University, Iida-Nishi 2-2-2, Yamagata, 990-9585, Japan. ., Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 0368562, Japan., Department of Urology, University of Tsukuba Graduate School of Medicine, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan., Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan., Department of Urology, Iwate Medical University School of Medicine, Yahaba 2-1-1, Shiwa, Iwate, 028-3695, Japan., Department of Urology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan., Department of Urology, Miyagi Cancer Center, 47-1 Nodayama, Shiote, Medeshima, Natori, Miyagi, 981-1293, Japan., Department of Urology, Tohoku University School of Medicine, 1-1, Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan.