Department of Urology, Faculty of Medicine, Yamagata University, Iida-Nishi 2-2-2, Yamagata, 990-9585, Japan.
Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 0368562, Japan.
Int J Clin Oncol. 2023 Nov;28(11):1538-1544. doi: 10.1007/s10147-023-02401-2. Epub 2023 Sep 22.
The Modified International Metastatic Renal Cell Carcinoma Dataset Consortium model (mIMDC) is a preoperative prognostic model for pT3cN0M0 renal cell carcinoma (RCC). This study aimed to validate the mIMDC and to construct a new model in a localized and locally advanced RCC (LLRCC).
A database was established (the Michinoku Japan Urological Cancer Study Group database) consisting of 79 patients who were clinically diagnosed with LLRCC (cT3b/c/4NanyM0) and underwent radical nephrectomy from December 2007 to May 2018. Using univariable and multivariable analyses, we retrospectively analyzed disease-free survival (DFS) and overall survival (OS) in this database, constructed a new prognostic model according to these results, and estimated the model fit using c-index on the new and mIMDC models.
Independent poorer prognostic factors for both DFS and OS include the following: ≥ 1 Eastern Cooperative Oncology Group performance status, 2.0 mg/dL C-reactive protein, and > upper normal limit of white blood cell count. The median DFS in the favorable (no factor), intermediate (one factor), and poor-risk group (two or three factors) was 76.1, 14.3, and 4.0 months, respectively (P < 0.001). The 3-year OS in the favorable, intermediate, and poor-risk group were 92%, 44%, and 0%, respectively (P < 0.001). The c-indices of the new and mIMDC models were 0.67 and 0.60 for DFS (P = 0.060) and 0.74 and 0.63 for OS (P = 0.012), respectively.
The new preoperative prognostic model in LLRCC can be used in patient care and clinical trials.
改良国际转移性肾细胞癌数据集联盟模型（mIMDC）是 pT3cN0M0 肾细胞癌（RCC）的术前预后模型。本研究旨在验证 mIMDC 并构建局部和局部进展性 RCC（LLRCC）的新模型。
建立了一个数据库（日本三陆泌尿癌症研究组数据库），该数据库包含 79 名临床诊断为 LLRCC（cT3b/c/4NanyM0）并于 2007 年 12 月至 2018 年 5 月接受根治性肾切除术的患者。使用单变量和多变量分析，我们回顾性分析了该数据库中的无病生存（DFS）和总生存（OS），根据这些结果构建了一个新的预后模型，并使用新模型和 mIMDC 模型的 c 指数估计模型拟合度。
DFS 和 OS 的独立预后较差因素包括以下因素：≥1 个东部合作肿瘤学组体能状态、2.0mg/dL C 反应蛋白和白细胞计数超过正常值上限。DFS 良好（无因素）、中度（一个因素）和差风险组（两个或三个因素）的中位 DFS 分别为 76.1、14.3 和 4.0 个月（P<0.001）。3 年 OS 在良好、中度和差风险组中分别为 92%、44%和 0%（P<0.001）。新模型和 mIMDC 模型的 DFS 的 c 指数分别为 0.67 和 0.60（P=0.060），OS 的 c 指数分别为 0.74 和 0.63（P=0.012）。
新的 LLRCC 术前预后模型可用于患者护理和临床试验。
Zotero 插件