Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Pichler, M; Hutterer, GC; Chromecki, TF; Jesche, J; Groselj-Strele, A; Kampel-Kettner, K; Pummer, K; Zigeuner, R.
Prognostic value of the Leibovich prognosis score supplemented by vascular invasion for clear cell renal cell carcinoma.
J Urol. 2012; 187(3):834-839
Doi: 10.1016/j.juro.2011.10.155
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Hutterer Georg
- Pichler Martin
- Co-Autor*innen der Med Uni Graz
- Chromecki Thomas
- Groselj-Strele Andrea
- Jesche-Chromecki Johanna
- Pummer Karl
- Strini Karin
- Zigeuner Richard
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- Abstract:
- PURPOSE: We assessed whether supplementing the Leibovich prognosis score with vascular invasion would improve prognostic value to predict metastatic disease in patients with nonmetastatic clear cell renal cell carcinoma. MATERIALS AND METHODS: We retrospectively evaluated the pathology records of 1,754 patients with nonmetastatic clear cell renal cell carcinoma treated with surgery between 1984 and 2006 at a single tertiary academic center. The Leibovich prognosis score was supplemented by additional scoring for vascular invasion. Metastasis-free survival was assessed using the Kaplan-Meier method for each score category. A Cox regression model was used for multivariate testing. Predictive accuracy was determined by the Harrell concordance index and decision curve analysis. RESULTS: Median followup was 84 months. Ten-year metastasis-free survival probability for a score of 0 to 1 and 2 to 8 or greater was 95%, 83%, 78%, 81%, 69%, 51%, 15% and 13%, respectively. The concordance index was 0.792 compared to 0.778 from our external validation of the Leibovich prognosis score using routine pathological findings (p <0.05). Decision curve analysis also favored the predictive ability of the novel model. CONCLUSIONS: Adding vascular invasion improved the predictive accuracy of our validation data by 1.4% over that of the Leibovich prognosis score. Patients with a score of 7 or greater had a more than 85% probability of metastatic disease at 10 years. Thus, they could be considered candidates for adjuvant treatment trials.
Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved. - Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Carcinoma, Renal Cell - mortality Carcinoma, Renal Cell - pathology Carcinoma, Renal Cell - surgery
- Female -
- Humans -
- Kidney Neoplasms - mortality Kidney Neoplasms - pathology Kidney Neoplasms - surgery
- Male -
- Middle Aged -
- Models, Statistical -
- Neoplasm Invasiveness - pathology
- Neoplasm Staging -
- Nephrectomy - methods
- Predictive Value of Tests -
- Probability -
- Prognosis -
- Proportional Hazards Models -
- Retrospective Studies -
- Survival Analysis -
- Veins - pathology
- Find related publications in this database (Keywords)
- kidney
- carcinoma, renal cell
- prognosis
- neoplasm invasiveness
- veins