Predicting cancer-control outcomes in patients with renal cell carcinoma.
OBJECTIVE
Several novel treatment modalities have been introduced for patients across all renal cell carcinoma stages. Observation or a variety of minimally invasive approaches can be applied to small renal masses. Conversely, aggressive loco-regional resections may be performed for locally advanced disease. Cytoreductive partial nephrectomy has become an alternative to radical nephrectomy. Finally, targeted therapies improve cancer control in unresectable or metastatic renal cell carcinoma. The variety of modes and stages at presentation and the number of treatment options may render medical decision-making highly complex. Various prognostic models and nomograms can assist with treatment decision-making in patients with renal cell carcinoma.


RESULTS
The multivariable risk-factor approach to renal cell carcinoma-specific mortality has been pioneered. In 1999 was proposed a multivariate model for prediction of individual survival in patients with metastatic renal cell carcinoma. Since then several prenephrectomy and postnephrectomy models have been developed. These models can be distinguished according to their target populations, discriminant properties (accuracy of predictions) and confirmed validity within independent cohorts.


CONCLUSIONS
We give a comparative outline of these model characteristics within existing tools. Our work provides the clinician with a complete list of such tools, including comparisons of their relative advantages and disadvantages.
Karakiewicz
Pierre I
PI
Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada. pierre.karakiewicz@umontreal.ca
Hutterer
Georg C
GC
D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003657:Decision Making; D018572:Disease-Free Survival; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008954:Models, Biological; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D049451:Nomograms; D018579:Patient Selection; D012008:Recurrence; D015203:Reproducibility of Results; D016896:Treatment Outcome