title: Predictive ability of the 2002 and 2010 versions of the Tumour-Node-Metastasis classification system regarding metastasis-free, cancer-specific and overall survival in a European renal cell carcinoma single-centre series.
abstract: OBJECTIVE
  To compare the predictive ability of the Tumour-Node-Metastasis (TNM) classification systems for renal cell carcinoma (RCC) using three different endpoints: metastasis-free (MFS); overall (OS); and cancer-specific survival (CSS).
  
  
  METHODS
  Data from 2739 consecutive patients with RCC, who underwent surgery at a single academic centre, were evaluated using multivariate Cox proportional models, Harrell's concordance (c)-index and by applying decision curve analysis (DCA) with regard to MFS, OS and CSS.
  
  
  RESULTS
  According to TNM 2010, significant differences for MFS were observed for pT1a vs pT1b, pT1b vs pT2a, pT3a vs pT3b and pT3b vs pT3c stages, respectively (all P < 0.05). With regard to OS, significant differences could be observed in pT1a vs pT1b and pT3a vs pT3b stages, respectively (all P < 0.05). The c-index for CSS, OS and MFS was slightly higher for the 2002 than for the 2010 version of the TNM classification system. Non-inferiority of the 2002 TNM system is supported by the results of the DCA.
  
  
  CONCLUSIONS
  According to our data, the predictive ability of the 2010 version of the TNM classification system regarding three different clinical endpoints is not superior to the 2002 version of this staging system.
authors.affiliation: Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria. martin.pichler@medunigraz.at
authors.forename: Martin
authors.initials: M
authors.lastname: Pichler
authors.forename: Georg C
authors.initials: GC
authors.lastname: Hutterer
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Chromecki
authors.forename: Johanna
authors.initials: J
authors.lastname: Jesche
authors.forename: Karin
authors.initials: K
authors.lastname: Kampel-Kettner
authors.forename: Andrea
authors.initials: A
authors.lastname: Groselj-Strele
authors.forename: Karl
authors.initials: K
authors.lastname: Pummer
authors.forename: Richard
authors.initials: R
authors.lastname: Zigeuner
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000145:classification* / Q000401:mortality / Q000556:secondary; D018572:Disease-Free Survival; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification* / Q000401:mortality / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends