Cell cycle progression score has potential prognostic value for stage T1 renal cell carcinomas

Abstract

BackgroundThere is an ongoing effort to identify a biomarker which predicts metastatic progression of renal cell carcinoma (RCC). ObjectiveTo evaluate the utility of the cell cycle progression (CCP) score biomarker in predicting metastasis in RCC after local resection of pathologic T1 disease. Design, setting, and participantsPathologic T1 tumors at the University of Iowa were reviewed in patients who had a radical or partial nephrectomy between 1995 and 2010. Patients with known or suspected metastasis, who had received chemotherapy, or who developed metastasis within 60 days of surgery were excluded. Final analysis included 163 patients with RCC who developed metastasis or a new primary within 5 years after surgery or had been followed for 5 years without developing metastasis. Intervention(s)Expression levels of 31 cell cycle genes and 15 control genes from the tumor were measured and reported as a CCP score. Outcome measurements and statistical analysisThe sensitivity, specificity, positive predictive value, and negative predictive value for the development of a metastasis or new primary within 5 years of resection was calculated for varying CCP score cutoffs. Results and limitationsA total of 4 (2.5%) patients developed metastasis and 7 (4.3%) developed a new primary renal tumor. A CCP score of >−0.25 had a 100% sensitivity and 43% specificity for predicting metastatic progression. A CCP score of >−0.7 had a 100% sensitivity and 20% specificity for predicting the development of a new renal primary. ConclusionsThe CCP score has potential prognostic value in predicting metastatic progression and might be a useful tool for the management of patients with RCC. Patient summaryIn this study we looked at the utility of a particular gene expression profile from kidney tumors. We found that this gene expression test has the potential to identify tumors at risk of metastasis and thus could be a useful tool in the management of patients with kidney tumors.