Multi-institutional validation of a new renal cancer-specific survival nomogram.


PURPOSE We tested the hypothesis that the prediction of renal cancer-specific survival can be improved if traditional predictor variables are used within a prognostic nomogram. PATIENTS AND METHODS Two cohorts of patients treated with either radical or partial nephrectomy for renal cortical tumors were used: one (n = 2,530) for nomogram development and for internal validation (200 bootstrap resamples), and a second (n = 1,422) for external validation. Cox proportional hazards regression analyses modeled the 2002 TNM stages, tumor size, Fuhrman grade, histologic subtype, local symptoms, age, and sex. The accuracy of the nomogram was compared with an established staging scheme. RESULTS Cancer-specific mortality was observed in 598 (23.6%) patients, whereas 200 (7.9%) died as a result of other causes. Follow-up ranged from 0.1 to 286 months (median, 38.8 months). External validation of the nomogram at 1, 2, 5, and 10 years after nephrectomy revealed predictive accuracy of 87.8%, 89.2%, 86.7%, and 88.8%, respectively. Conversely, the alternative staging scheme predicting at 2 and 5 years was less accurate, as evidenced by 86.1% (P = .006) and 83.9% (P = .02) estimates. CONCLUSION The new nomogram is more contemporary, provides predictions that reach further in time and, compared with its alternative, which predicts at 2 and 5 years, generates 3.1% and 2.8% more accurate predictions, respectively.

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@article{Karakiewicz2007MultiinstitutionalVO, title={Multi-institutional validation of a new renal cancer-specific survival nomogram.}, author={Pierre I. Karakiewicz and Alberto Briganti and Felix K-H Chun and Quoc-Dien Trinh and Paul Perrotte and Vincenzo Ficarra and Luca Cindolo and Alexandre de la Taille and Jacques Tostain and Peter F. A. Mulders and Laurent Salomon and Richard E Zigeuner and Tommaso Prayer-Galetti and Denis Chautard and Antoine Val{\'e}ri and {\'E}ric Lechevallier and Jean-Luc Descotes and Herv{\'e} Lang and Arnaud M{\'e}jean and Jean-Jacques Patard}, journal={Journal of clinical oncology : official journal of the American Society of Clinical Oncology}, year={2007}, volume={25 11}, pages={1316-22} }