ECOG performance status 0 or 1 and symptom classification do not improve the ability to predict renal cell carcinoma-specific survival.
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.
Karakiewicz
Pierre I
PI
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
Trinh
Quoc-Dien
QD
de la Taille
Alexandre
A
Abbou
Claude C
CC
Salomon
Laurent
L
Tostain
Jacques
J
Cindolo
Luca
L
Artibani
Walter
W
Ficarra
Vincenzo
V
Patard
Jean-Jacques
JJ
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