Xia Mancheng, Yang Haosen, Wang Yusheng, Yin Keqiang, Bian Xiaodong, Chen Jiawei, Shuang Weibing
First Clinical Medical College, Shanxi Medical University, Taiyuan, People's Republic of China.
Kidney Transplantation Center, Shanxi Second People's Hospital, Taiyuan, People's Republic of China.
Cancer Manag Res. 2020 Jun 11;12:4461-4473. doi: 10.2147/CMAR.S250371. eCollection 2020.
To develop and validate a nomogram for predicting the overall survival (OS) of renal cell carcinoma (RCC) patients after nephrectomy.
In total, 488 patients with RCC who underwent nephrectomy at the Urology Department of the First Hospital of Shanxi Medical University between January 2013 and December 2018 were randomly divided into a development cohort (n = 344) and a validation cohort (n = 144). The development cohort was used to build a prediction model, and the validation cohort was used for validation. Single-factor and multifactor analyses were carried out with R software, and the nomogram, calibration chart, ROC curve and C index were constructed.
The median follow-up time of the development and validation cohorts was 34 months. The total 3-year and 5-year survival rates of the development cohort were 93.3% and 91.6%, respectively; those of the validation cohort were 92.4% and 91.0%, respectively. Cox univariate analysis of the development cohort showed that age, type 2 diabetes mellitus (T2DM), smoking history, type of surgery, T stage, N stage, M stage and Fuhrman nuclear grade were prognostic factors for OS in RCC patients undergoing nephrectomy. Cox multivariate analysis showed that T2DM, smoking history and T stage were independent prognostic factors for OS in RCC patients undergoing nephrectomy (P < 0.05). According to the univariate and multivariate analyses, a nomogram was constructed. In the development cohort, the C index of predicted OS was 0.875 (95% CI, 0.820-0.930). The calibration curve of the 3-year and 5-year survival rates showed that the predicted value of the nomogram was consistent with the actual observed value. The area under the 3-year and 5-year survival ROC curves was 0.861 and 0.901, respectively. In the validation cohort, the C index was 0.880 (95% CI, 0.778-0.982). The calibration curve of the 3-year and 5-year survival rates showed that the predicted value of the nomogram was consistent with the actual observed value. The area under the 3-year and 5-year survival ROC curves was 0.813 and 0.799, respectively.
We developed and verified a new and accurate nomogram with available clinicopathological data that can effectively predict the OS of RCC patients after nephrectomy.
开发并验证一种用于预测肾细胞癌（RCC）患者肾切除术后总生存期（OS）的列线图。
选取2013年1月至2018年12月在山西医科大学第一医院泌尿外科接受肾切除术的488例RCC患者，随机分为开发队列（n = 344）和验证队列（n = 144）。开发队列用于构建预测模型，验证队列用于验证。使用R软件进行单因素和多因素分析，并构建列线图、校准图、ROC曲线和C指数。
开发队列和验证队列的中位随访时间均为34个月。开发队列的3年和5年总生存率分别为93.3%和91.6%；验证队列的分别为92.4%和91.0%。开发队列的Cox单因素分析显示，年龄、2型糖尿病（T2DM）、吸烟史、手术类型、T分期、N分期、M分期和Fuhrman核分级是接受肾切除术的RCC患者OS的预后因素。Cox多因素分析显示，T2DM、吸烟史和T分期是接受肾切除术的RCC患者OS的独立预后因素（P < 0.05）。根据单因素和多因素分析构建列线图。在开发队列中，预测OS的C指数为0.875（95%CI，0.820 - 0.930）。3年和5年生存率的校准曲线显示，列线图的预测值与实际观察值一致。3年和5年生存ROC曲线下面积分别为0.861和0.901。在验证队列中，C指数为0.880（95%CI，0.778 - 0.982）。3年和5年生存率的校准曲线显示，列线图的预测值与实际观察值一致。3年和5年生存ROC曲线下面积分别为0.813和0.799。
我们利用可用的临床病理数据开发并验证了一种新的、准确的列线图，可有效预测RCC患者肾切除术后的OS。
