Patients with distant metastases from renal cell carcinoma can be accurately identified: external validation of a new nomogram.
OBJECTIVE
To identify clinical variables that can accurately predict the presence of distant metastases in patients with renal cell carcinoma (RCC).


METHODS
Age, symptom classification, tumour size and the prevalence of distant metastases at diagnosis before nephrectomy were available for 5376 patients with pathologically confirmed RCC. The data of 2660 (49.5%) patients from 11 centres were used to develop a multivariable logistic regression model-based nomogram predicting the individual probability of distant metastases. The remaining data from 2716 (50.5%) patients from three institutions were used for external validation.


RESULTS
In the development cohort, 269/2660 (10.1%) had distant metastases, vs 285/2716 (10.5%) in the external validation cohort. Symptom classification and tumour size were independent predictors of distant metastases in the development cohort; age was not an independent predictor. A nomogram based on symptom classification and tumour size was 85.2% accurate in predicting the individual probability of distant metastases in the external validation cohort.


CONCLUSIONS
Although distant metastases might be easily identifiable in some patients, their diagnosis might be a challenge in others. The current nomogram provides a simple, user-friendly and, most importantly, an accurate tool aimed at predicting the probability of distant metastases in patients with RCC.
Hutterer
Georg C
GC
Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada.
Patard
Jean-Jacques
JJ
Jeldres
Claudio
C
Perrotte
Paul
P
de La Taille
Alexandre
A
Salomon
Laurent
L
Verhoest
Gregory
G
Tostain
Jacques
J
Cindolo
Luca
L
Ficarra
Vincenzo
V
Artibani
Walter
W
Schips
Luigi
L
Zigeuner
Richard
R
Mulders
Peter F
PF
Karakiewicz
Pierre I
PI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009392:Nephrectomy; D049451:Nomograms; D012189:Retrospective Studies; D012307:Risk Factors