Preoperative prognostic model for localized and locally advanced renal cell carcinoma—Michinoku Japan Urological Cancer Study Group

Abstract

Abstract Background The Modified International Metastatic Renal Cell Carcinoma Dataset Consortium model (mIMDC) is a preoperative prognostic model for pT3cN0M0 renal cell carcinoma (RCC). This study aimed to validate the mIMDC and to construct a new model in a localized and locally advanced RCC (LLRCC). Methods A database was established (the Michinoku Japan Urological Cancer Study Group database) consisting of 65 patients who were clinically diagnosed with LLRCC (cT3b/c/4NanyM0) and underwent radical nephrectomy from December 2007 to May 2018. Using univariable and multivariable analyses, we retrospectively analyzed disease-free survival (DFS) and overall survival (OS) in this database, constructed a new prognostic model according to these results, and estimated the model fit using c-index on the new and mIMDC models. Results Independent poorer prognostic factors for both DFS and OS include the following: ≥1 Eastern Cooperative Oncology Group performance status, 2.0 mg/dL C-reactive protein, and > upper normal limit of white blood cell count. The median DFS in the favorable (no factor), intermediate (one factor), and poor-risk group (two or three factors) was 101.8, 18.2, and 4.0 months, respectively (P < 0.001). The 3-year OS in the favorable, intermediate, and poor-risk group were 100%, 54%, and 0%, respectively (P < 0.001). The c-indices of the new and mIMDC models were 0.73 and 0.66 for DFS (P = 0.065) and 0.86 and 0.73 for OS (P = 0.006), respectively. Conclusion The new preoperative prognostic model in LLRCC can be used in patient care and clinical trials.