To develop the clinical calculator for mortality of patients with metastatic renal cell carcinoma (mRCC) using Korean Renal Cancer Study Group (KRoCS) database.
Data from 1,115 patients with mRCC treated in 4 hospitals joining KRoCS between 1993 and 2016 were pooled. Five-year survival rates were calculated using Kaplan-Meier curve. A clinical calculator for 5-year mortality was developed using multivariable logistic regression analysis and validated externally using dataset including 916 patients from 4 other hospitals.
Overall survival rates and cancer specific survival rate at 5 years were 28.5% and 29.4%, respectively. Among baseline factors, increased neutrophil-lymphocyte ratio (≥4), synchronous metastasis, low albumin (<3.0 g/dL), and low hemoglobin (<lower limit of normal: male, 13 g/dL; female, 11.5 g/dL) were the significant factors in 5-year mortality. Good internal validity was demonstrated with area under the curve estimates being 0.774 at 5-year mortality calculation and the calibration plot. In the external validation, 758 (82.8%) died by 5 years among these patients, with the average model-predicted rate of 72.9%.
A clinical calculator has been developed to quantify the risk of death for individual patients after treatment of mRCC. This tool may be useful for patients or their guardians who want to know their prognosis and to identify patients requiring aggressive therapy and additional supportive measures during and after treatment.
Investigative and clinical urology. 2020 Mar 10 [Epub]
Jae Young Park, Bum Sik Tae, Chang Wook Jeong, Cheryn Song, Seong Il Seo, Sung Kyu Hong, Jinsoo Chung, Sung-Hoo Hong, Eu Chang Hwang, Cheol Kwak, Ill Young Seo, Suyeon Park, Chanwang Park, Korean Renal Cancer Study Group
Department of Urology, Korea University Ansan Hospital, Ansan, Korea., Department of Urology, Seoul National University Hospital, Seoul, Korea., Department of Urology, Asan Medical Center, Seoul, Korea., Department of Urology, Samsung Medical Center, Seoul, Korea., Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea., Department of Urology, National Cancer Center, Goyang, Korea., Department of Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea., Department of Urology, Chonnam National University Hwasun Hospital, Hwasun, Korea., Department of Urology, Wonkwang University Hospital, Iksan, Korea., Department of Biostatistics, Soonchunhyang University Seoul Hospital, Seoul, Korea., Anesthesia Consultants of Indianapolis, Indianapolis, IN, USA.