Korean J Urol.  2006 Sep;47(9):963-967. 10.4111/kju.2006.47.9.963.

Korean Nomogram for the Prediction of Recurrence-free Survival after Definitive Surgery for Renal Cell Carcinoma

• Song C
• Park JY
• Lee MS
• Chung H
• Cho YH
• Kim BW
• Chang SG
• Kim CI
• Cheon J
• Lee KS
• Chung SI
• Chung MK
• Choi HY
• Lee HM
• Kim SJ
• Hong SJ
• Chung JI
• Yoon SM
• Lee YG
• Kim HJ
• Kim H
• Kim WJ
• Ryu SB
• Ahn H
• Kim CS

• KMID: 2294092
• DOI: http://doi.org/10.4111/kju.2006.47.9.963

Abstract

Purpose
This multiinstitutional study was to investigate the accuracy of the Kattan nomograms for the prediction of recurrence after definitive surgery for renal cell carcinoma (RCC) in Korean patients and develop a nomogram revised to complement the shortcomings.
Materials and Methods
Clinical and pathological data of 1,866 patients with RCC who had been followed for at least 2 years after surgery in each participating institutes were reviewed as well as evidence of disease recurrence, defined to include local recurrence and distant metastasis. Accuracy of the Kattan nomograms' predictability in tumors 7cm or less was tested by calculating the area under the receiver-operating characteristics curve (AUC) and actuarial recurrence-free survival by Kaplan- Meier method. We used the Cox proportional hazard analysis to identify significant variables and develop prediction nomogram, and internally validated by bootstrapping method. Mean follow-up was 56.5 months (24-184).
Results
Recurrence occurred in 12.5% of the patients and correlated with the pathological stage, with 4.3%, 7.9%, 15.0%, 22.6%, 38.4%, 58.3% for stages T1a, T1b, T2, T3a, T3b/c and T4, respectively (p<0.001). The AUC of the Kattan nomograms was 0.276. Factors significantly predictive of recurrence were T stage (p<0.0001), presentation (p=0.006), preoperative hemoglobin (p=0.023) and gender (p=0.032). Actuarial 60-month recurrence- free survival was 87.9% and using the prognostic factors, nomogram predicting 60-month recurrence-free survival was constructed.
Conclusions
Korean nomogram complementing the preexisting nomograms for the prediction of recurrence-free survival after definitive surgery for RCC has been constructed, which may be useful in patient prognostication, counseling and follow-up planning.

Keyword

Renal neoplasm; Survival; disease free; Nomograms

MeSH Terms

Academies and Institutes
Area Under Curve
Carcinoma, Renal Cell*
Complement System Proteins
Counseling
Follow-Up Studies
Humans
Kidney Neoplasms
Neoplasm Metastasis
Nomograms*
Recurrence
Complement System Proteins

Figure

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  Fig. 1 Receiver-operating characteristics curve of the Kattan nomograms for tumors of sizes 7cm or less (AUC=0.276).

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  Fig. 2 Established nomogram for the prediction of 60-month recurrence-free survival.

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