MP55-13 COMPARING PREDICTIVE ACCURACY FOR FOUR PROGNOSTIC MODELS OF RECURRENCE FOLLOWING SURGERY IN NON-METASTATIC RENAL CELL CARCINOMA WITH THROMBUS USING CONTEMPORARY DATA FROM SIX INSTITUTIONS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III1 Apr 2017MP55-13 COMPARING PREDICTIVE ACCURACY FOR FOUR PROGNOSTIC MODELS OF RECURRENCE FOLLOWING SURGERY IN NON-METASTATIC RENAL CELL CARCINOMA WITH THROMBUS USING CONTEMPORARY DATA FROM SIX INSTITUTIONS Shivashankar Damodaran, Jose A. Karam, Timothy A. Masterson, Viraj A. Master, Vitaly Margulis, Datta Patil, Tyler Bauman, Michael Blute, Jr., Evan Bloom, Haley Robyak, Matthew Kaag, Jay D. Raman, Christopher G. Wood, and E. Jason Abel Shivashankar DamodaranShivashankar Damodaran More articles by this author , Jose A. KaramJose A. Karam More articles by this author , Timothy A. MastersonTimothy A. Masterson More articles by this author , Viraj A. MasterViraj A. Master More articles by this author , Vitaly MargulisVitaly Margulis More articles by this author , Datta PatilDatta Patil More articles by this author , Tyler BaumanTyler Bauman More articles by this author , Michael Blute, Jr.Michael Blute, Jr. More articles by this author , Evan BloomEvan Bloom More articles by this author , Haley RobyakHaley Robyak More articles by this author , Matthew KaagMatthew Kaag More articles by this author , Jay D. RamanJay D. Raman More articles by this author , Christopher G. WoodChristopher G. Wood More articles by this author , and E. Jason AbelE. Jason Abel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1706AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Predictive models for recurrence in non-metastatic renal cell carcinoma (RCC) have been developed from general populations of RCC patients, including very few high risk patients. According, these models may not be ideal to stratify high risk patients for enrollment in adjuvant clinical trials such as patients with venous tumor thrombus. The purpose of this study was to compare predictive accuracy for a nomogram developed from non-metastatic RCC patients with venous tumor thrombus with 3 existing prognostic models for RCC recurrence following surgery. METHODS A nomogram was developed from independent predictors after multivariable modeling of common clinical and pathologic variables. Receiver operator characteristic (ROC) curves were constructed to compare predictive accuracy of the nomogram with the University of California-Los Angeles Integrated Staging System(UISS), Stage Size Grade Necrosis (SSIGN) and Sorbellini models. RESULTS A total of 669 consecutive non-metastatic RCC patients with tumor thrombus were treated surgically from 2000-2014 at 6 institutions. Variables independently associated with RCC recurrence were increased tumor diameter per centimeter, body mass index per point, preoperative hemoglobin < lower limit of normal, IVC thrombus level above hepatic vein, perinephric fat invasion, and non-clear cell histology. Estimated overall 5-year RFS was 49%. A nomogram was developed using weighted variables in a development cohort (n=465) and validated in a separate cohort (n=204). The AUC for the thrombus nomogram was 0.738, which was significantly higher than AUC for the Sorbellini model (0.623), UISS model (0.615) and SSIGN model (0.584). CONCLUSIONS A nomogram developed specifically for non-metastatic RCC patients with venous tumor thrombus has significantly greater predictive accuracy than general prognostic models in this high risk population. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e735-e736 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Shivashankar Damodaran More articles by this author Jose A. Karam More articles by this author Timothy A. Masterson More articles by this author Viraj A. Master More articles by this author Vitaly Margulis More articles by this author Datta Patil More articles by this author Tyler Bauman More articles by this author Michael Blute, Jr. More articles by this author Evan Bloom More articles by this author Haley Robyak More articles by this author Matthew Kaag More articles by this author Jay D. Raman More articles by this author Christopher G. Wood More articles by this author E. Jason Abel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...