title: A Three-Variable Model Predicts Short Survival in Patients With Newly Diagnosed Metastatic Renal Cell Carcinoma.
abstract: BACKGROUND
  Patients with metastatic renal cell carcinoma (mRCC) have variable survival outcomes. When discussing management approaches and providing information to patients and caregivers, it is important to have realistic perspectives, especially if the expected prognosis is very unfavorable. In the present study, factors predicting this endpoint were analyzed.
  
  
  METHODS
  Data from 60 patients treated in routine clinical practice were evaluated. Unfavorable prognosis was defined as death within approximately 3 months from diagnosis of mRCC (maximum 3.5 months). Baseline factors including laboratory values and management approach were compared between the groups with short and longer survival.
  
  
  RESULTS
  A total of 48 patients (80%) experienced ≥ 4 months survival (4+MS) and 10 (16.7%) experienced shorter survival (3MS). The others had short follow-up. Adverse prognostic factors that were significantly more frequent in the 3MS group were low hemoglobin, high lactate dehydrogenase and lack of systemic therapy. We used these three items to create a prognostic model: score 0 = no adverse factors, score 1 = one adverse factor, score 2 = two adverse factors, score 3 = three adverse factors. In the score 0 group, one out of 20 patients experienced 3MS (5%). In score 1, two out of 21 patients belonged to the 3MS group (9.5%). For score 2, the corresponding figure was four out of 14 patients (29%). In the score 3 group, three out of three patients experienced 3MS (100%) (P = 0.0001).
  
  
  CONCLUSIONS
  A simple model with three prognostic factors predicted survival of patients with newly diagnosed mRCC. Additional validation in other databases is warranted.
authors.affiliation: Department of Oncology and Palliative Medicine, Nordland Hospital, Bodo 8092, Norway.
authors.forename: Mohsan Ali
authors.initials: MA
authors.lastname: Syed
authors.affiliation: Department of Oncology and Palliative Medicine, Nordland Hospital, Bodo 8092, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromso 9037, Norway.
authors.forename: Carsten
authors.initials: C
authors.lastname: Nieder
keywords: Kidney cancer; Metastatic renal cell carcinoma; Prognostic factors; Prognostic score; Systemic therapy