MP54-11 5-YEAR RECURRENCE RISK STRATIFICATION USING THE RECURRENCE OF KIDNEY STONE (ROKS) NOMOGRAM

Abstract

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II (MP54)1 Sep 2021MP54-11 5-YEAR RECURRENCE RISK STRATIFICATION USING THE RECURRENCE OF KIDNEY STONE (ROKS) NOMOGRAM Nicholas Kavoussi, Alexandre Da Silva, Allison McCoy, Tatsuki Koyama, and Ryan Hsi Nicholas KavoussiNicholas Kavoussi More articles by this author , Alexandre Da SilvaAlexandre Da Silva More articles by this author , Allison McCoyAllison McCoy More articles by this author , Tatsuki KoyamaTatsuki Koyama More articles by this author , and Ryan HsiRyan Hsi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002084.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Recurrence of Kidney Stones (ROKS) nomogram predicts subsequent symptomatic kidney stone recurrence. However, while external validation studies have shown fair predictive performance for predicting percentile risk, the predictive performance of ROKS to assign patients into categorical risk groups is unknown. Therefore, we sought to assess the performance of the ROKS nomogram for risk stratification in a retrospective study. METHODS: We performed a case-control study of 200 patients (100 with and 100 without subsequent recurrence) who underwent kidney stone surgery between 2013-2015, and had at least 5 years of follow-up imaging and clinic visits for stone disease. We analyzed the performance of the 2018 ROKS nomogram via area under the receiver operating curve (ROC-AUC) for predicting 5-year symptomatic or radiographic recurrence. Then, sensitivity and specificity optimization was performed to best delineate patients between low and high risks of recurrence. Time-to-recurrence data were estimated using the Kaplan Meier method and compared by log rank testing. RESULTS: The ROKS nomogram demonstrated fair ability to predict recurrence (ROC-AUC= 0.63). A threshold of 60% predicted 5-year recurrence risk delineated lower and higher risk groups with a sensitivity and specificity optimized at 0.58 (0.48-0.68, 95% CI) and 0.63 (0.53-0.72, 95% CI) respectively(see Figure). The lower and higher risk groups had a ROKS-predicted mean 5-year recurrence risk of 40% and 76%, respectively. Kaplan-Meier analysis revealed a significant recurrence-free advantage between the groups (p=0.001, Fig. 1). Examining the outcome of symptomatic recurrence only showed similar results. CONCLUSIONS: The ROKS nomogram has potential to serve as a tool for recurrence risk stratification into lower and higher risk groups, which may facilitate adherence to risk-based follow-up protocols. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e953-e953 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicholas Kavoussi More articles by this author Alexandre Da Silva More articles by this author Allison McCoy More articles by this author Tatsuki Koyama More articles by this author Ryan Hsi More articles by this author Expand All Advertisement Loading ...