title: ECOG performance status 0 or 1 and symptom classification do not improve the ability to predict renal cell carcinoma-specific survival.
abstract: OBJECTIVE
  We tested and compared the improvement in prognostic ability related to the consideration of either ECOG performance status (ECOGPS) and/or symptom classification (S-CLASS) in renal cell carcinoma specific mortality (RCC-SM) predictions.
  
  
  METHODS
  Univariate and multivariate Cox regression analyses targeted RCC-SM in 2570 RCC patients treated with either partial or radical nephrectomy. The increment in predictive accuracy related to the addition of either ECOGPS, S-CLASS or both was quantified using Harrell's concordance index.
  
  
  RESULTS
  Follow-up ranged from 0.1 to 23 years (median 3.2) and 610 patients (23.7%) died of RCC. In multivariable analyses, ECOGPS and S-CLASS represented independent predictors of RCC-SM. The addition of ECOGPS to established RCC-SM predictors increased the predictive accuracy by 0.3% (p=0.8) versus 0.6% (p=0.5) for S-CLASS versus 0.6% (p=0.5) for both.
  
  
  CONCLUSIONS
  Neither ECOGPS nor S-CLASS improves the ability to predict RCC-SM. Therefore, these variables may be safely omitted when RCC-SM risk is quantified.
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center (CHUM), 1058, rue St-Denis, Montreal, Que., Canada H2X 3J4. pierre.karakiewicz@umontreal.ca
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.forename: Alexandre
authors.initials: A
authors.lastname: de la Taille
authors.forename: Claude C
authors.initials: CC
authors.lastname: Abbou
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.forename: Jacques
authors.initials: J
authors.lastname: Tostain
authors.forename: Luca
authors.initials: L
authors.lastname: Cindolo
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000601:surgery; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000401:mortality*; D011379:Prognosis; D012720:Severity of Illness Index