Use of the University of California Los Angeles integrated staging system to predict survival in renal cell carcinoma: an international multicenter study.
OBJECTIVE
To evaluate ability of the University of California Los Angeles Integrated Staging System (UISS) to stratify patients with localized and metastatic renal cell carcinoma (RCC) into risk groups in an international multicenter study.


METHODS
4,202 patients from eight international academic centers were classified according to the UISS, which combines TNM stage, Fuhrman grade, and Eastern Cooperative Oncology Group performance status. Distribution of the UISS categories was assessed in the overall population and in each center.


RESULTS
The UISS stratified both localized and metastatic RCC into three different risk groups (P <.001). For localized RCC, the 5-year survival rates were 92%, 67%, and 44% for low-, intermediate-, and high-risk groups, respectively. A trend toward a higher risk of death was observed in all centers for increasing UISS risk category. For metastatic RCC, the 3-year survival rates were 37%, 23%, and 12% for low-, intermediate-, and high-risk groups, respectively; in 6 of 8 centers, a trend toward a higher risk of death was observed for increasing UISS risk category. A greater variability in survival rates among centers was observed for high-risk patients.


CONCLUSIONS
This study defines the general applicability of the UISS for predicting survival in patients with RCC. The UISS is an accurate predictor of survival for patients with localized RCC applicable to external databases. Although the UISS may be useful for patients with metastatic RCC, it may be less accurate in this subset of patients due to the heterogeneity of patients and treatments.
Department of Urology, Rennes University Hospital, France.
Jean-Jacques
JJ
Patard
Hyung L
HL
Kim
John S
JS
Lam
Frederick J
FJ
Dorey
Allan J
AJ
Pantuck
Amnon
A
Zisman
Vincenzo
V
Ficarra
Ken-Ryu
KR
Han
Luca
L
Cindolo
Alexandre
A
De La Taille
Jacques
J
Tostain
Walter
W
Artibani
Colin P
CP
Dinney
Christopher G
CG
Wood
David A
DA
Swanson
Claude C
CC
Abbou
Bernard
B
Lobel
Peter F A
PF
Mulders
Dominique K
DK
Chopin
Robert A
RA
Figlin
Arie S
AS
Belldegrun
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000145:classification* / Q000473:pathology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis