title: A proposal of post-operative nomogram for overall survival in patients with renal cell carcinoma and venous tumor thrombus.
abstract: OBJECTIVE
  To identify the predictors of overall survival (OS) and create a post-operative prognostic model for patients with renal cell carcinoma (RCC) and venous tumor thrombus (VTT).
  
  
  METHODS
  The study cohort included patients with RCC and VTT that underwent full surgical resection between 2006 and 2016. Univariate and multivariate analyses were used to determine the prognostic factors of OS. A nomogram was developed and internally calibrated by bootstrap resampling method.
  
  
  RESULTS
  A total of 185 patients were identified, including patients with thrombus present in the renal vein (109 patients, 58.9%), infrahepatic inferior vena cava (IVC; 68 patients, 36.8%), and suprahepatic IVC (8 patients, 4.3%). After a median follow-up of 30.2 months (interquartile range, 12.1-48.4 months), 63 (34.1%) patients died. Independent prognostic factors for OS included histological subtype, collecting system invasion, metastasis at surgery, De Ritis ratio (AST/ALT), and serum albumin. Independently predictive variables were used to create a nomogram, which achieved a concordance index of 0.75 for OS.
  
  
  CONCLUSIONS
  For patients with RCC and VTT, the developed and internally validated post-operative nomogram can be used to select patients who may benefit from aggressive surveillance regimens or adjuvant therapy clinical trials.
authors.affiliation: Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, PLA Medical School, Beijing, China.
authors.forename: Liangyou
authors.initials: L
authors.lastname: Gu
authors.affiliation: Institute of Occupational Health, Beijing Center for Disease Control and Prevention, Beijing, China.
authors.forename: Zihuan
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, PLA Medical School, Beijing, China.
authors.forename: Luyao
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, PLA Medical School, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, PLA Medical School, Beijing, China.
authors.forename: Hongzhao
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, PLA Medical School, Beijing, China.
authors.forename: Wenyuan
authors.initials: W
authors.lastname: Nie
authors.affiliation: Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, PLA Medical School, Beijing, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Peng
authors.affiliation: Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, PLA Medical School, Beijing, China.
authors.forename: Xintao
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, PLA Medical School, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, PLA Medical School, Beijing, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
mesh_terms: D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000601:surgery; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009392:Nephrectomy; D049451:Nomograms; D011379:Prognosis; D012082:Renal Veins / Q000601:surgery; D012189:Retrospective Studies; D012709:Serum Albumin; D017131:Thrombectomy; D014682:Vena Cava, Inferior / Q000601:surgery; D020246:Venous Thrombosis / Q000209:etiology / Q000401:mortality* / Q000601:surgery
chemical_list: D012709:Serum Albumin
keywords: biomarker; nomogram; prognosis; renal cell carcinoma; thrombus