title: Evaluation of a new prognostic score (Munich score) to predict long-term survival after resection of pulmonary renal cell carcinoma metastases.
abstract: BACKGROUND
  The aim of this single-center study was to analyze factors predicting long-term outcomes following surgical resection of pulmonary metastases in patients with renal cell carcinoma.
  
  
  METHODS
  Two hundred two consecutive patients entered the study. Overall survival was analyzed by the Kaplan-Meier method. Multivariate analysis was performed using Cox regression models.
  
  
  RESULTS
  In 175 cases (87%), curative resection of the pulmonary metastases was achievable, with median survival of 43 months. Multivariate analysis revealed complete metastasectomy (R0), metastasis size >3 cm, positive nodal status of the primary tumor, synchronous metastases, pleural infiltration, and tumor-infiltrated hilar or mediastinal lymph nodes as independent prognostic factors for survival. On the basis of these findings, a new scoring system (the Munich score) was established to predict survival, which discriminates 3 groups with low, intermediate, and high risk for poor outcomes (median survival, 90, 31, and 14 months, respectively, P < .001).
  
  
  CONCLUSIONS
  The aim of the Munich score is to define patients with low, intermediate, and high risk for poor survival and will help identify patients who may benefit from further adjuvant therapy.
authors.affiliation: Department of General and Thoracic Surgery, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Georgios
authors.initials: G
authors.lastname: Meimarakis
authors.forename: Martin
authors.initials: M
authors.lastname: Angele
authors.forename: Michael
authors.initials: M
authors.lastname: Staehler
authors.forename: Dirk-Andre
authors.initials: DA
authors.lastname: Clevert
authors.forename: Alexander
authors.initials: A
authors.lastname: Crispin
authors.forename: Dominik
authors.initials: D
authors.lastname: Rüttinger
authors.forename: Florian
authors.initials: F
authors.lastname: Löhe
authors.forename: Gerhard
authors.initials: G
authors.lastname: Preissler
authors.forename: Rudolf A
authors.initials: RA
authors.lastname: Hatz
authors.forename: Hauke
authors.initials: H
authors.lastname: Winter
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology*; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors