A Review of Integrated Staging Systems for Renal Cell Carcinoma

Meskawi, Malek; Sun, Maxine; Trinh, Quoc Dien; Bianchi, Marco; Hansen, Jens; Tian, Zhe; Rink, Michael; Ismail, Salima; Shariat, Shahrokh F.; Montorsi, Francesco; Perrotte, Paul; Karakiewicz, Pierre I.

doi:10.1016/j.eururo.2012.04.049

Cited by 99 publications

(76 citation statements)

References 78 publications

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“…Although several integrated staging systems (ISSs) have evolved and improved for prediction of prognosis and outcome for RCC, TNM staging system is still the most used clinical prognosticator and the essential guide to the evaluation of therapeutic options but is done on the basis of anatomical information [3,29]. Metastatic RCC (mRCC) is highly refractory to radiation and chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of EZH2 Expression and Activity in Renal Cell Carcinoma: A Prospective Study

Liu

Zhong

et al. 2013

PLoS ONE

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Increased expression of EZH2 correlates with aggressive clinical behavior in various malignancies. In this study, we aim to investigate the clinical and prognostic values of EZH2 expression and activity in tumor tissues and improve the risk stratification in patients with renal cell carcinoma after surgery. We analyzed EZH2 expression and its activity as indicated by H3K27me3 levels comprising 373 patients with renal cell carcinoma in our institute. Outcome was assessed as overall survival and disease free survival using Kaplan-Meier analysis. Prognostic values of EZH2 and H3K27me3 expression for clinical outcomes were evaluated by Cox regression analysis. We used receiver operating characteristic to calculate diagnostic accuracy. High EZH2 expression correlates with poor overall survival in all patients, especially in advanced RCC, which is an independent prognostic factor in disease free survival and overall survival. Compared with EZH2, H3K27me3 expression is not an independent prognostic factor. The expressions of H3K27me3 and EZH2 are not completely consistent, which might be due to complicated interaction of Polycomb Repressor Complex 2. A combination of EZH2 expression and TNM stage could have better prognostic value than do TNM stage or EZH2 expression alone in both sets for disease free survival and overall survival. These results imply that evaluating intratumoral EZH2 density might improve prognostic value to the TNM staging system and inform treatment decisions for patients with late-stage renal cell carcinoma.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of EZH2 Expression and Activity in Renal Cell Carcinoma: A Prospective Study

Liu

Zhong

et al. 2013

PLoS ONE

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“…To identify risk factors that are able to accurately predict the clinical outcome of RCC patients is of paramount importance. Such risk factors allow the assessment of the patient's individual risk profile and thereby facilitate the decision whether to perform adjuvant treatment or not (Crispen et al , 2008; Meskawi et al , 2012). Growing evidence suggest that an interactive relationship exists between haemostatic factors and tumour biology (Palumbo, 2008).…”

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confidence: 99%

High plasma fibrinogen level represents an independent negative prognostic factor regarding cancer-specific, metastasis-free, as well as overall survival in a European cohort of non-metastatic renal cell carcinoma patients

et al. 2013

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Background:In recent years, plasma fibrinogen has been ascribed an important role in the pathophysiology of tumour cell invasion and metastases. A relatively small-scale study has indicated that plasma fibrinogen levels may serve as a prognostic factor for predicting clinical outcomes in non-metastatic renal cell carcinoma (RCC) patients.Methods:Data from 994 consecutive non-metastatic RCC patients, operated between 2000 and 2010 at a single, tertiary academic centre, were evaluated. Analyses of plasma fibrinogen levels were performed one day before the surgical interventions. Patients were categorised using a cut-off value of 466 mg dl−1 according to a calculation by receiver-operating curve analysis. Cancer-specific (CSS), metastasis-free (MFS), as well as overall survival (OS) were assessed using the Kaplan–Meier method. To evaluate the independent prognostic impact of plasma fibrinogen level, a multivariable Cox regression model was performed for all three different endpoints.Results:High plasma fibrinogen levels were associated with various well-established prognostic factors, including age, advanced tumour stage, tumour grade and histologic tumour necrosis (all P<0.05). Furthermore, in multivariable analysis, a high plasma fibrinogen level was statistically significantly associated with a poor outcome for patients' CSS (hazard ratio (HR): 2.47, 95% confidence interval (CI): 1.49–4.11, P<0.001), MFS (HR: 2.15, 95% CI: 1.44–3.22, P<0.001) and OS (HR: 2.48, 95% CI: 1.80–3.40, P<0.001).Conclusion:A high plasma fibrinogen level seems to represent a strong and independent negative prognostic factor regarding CSS, MFS and OS in non-metastatic RCC patients. Thus, this easily determinable laboratory value should be considered as an additional prognostic factor for RCC patients' individual risk assessment.

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“…different populations from different countries. 25 However, the best-performing model remains unknown.…”

Section: Resultsmentioning

confidence: 99%

Accuracy capabilities comparisons between Karakiewicz, Kattan and Cindolo nomograms in predicting outcomes for renal cancer carcinoma: A systematic review and meta-analysis

Russo¹,

Rosa²,

Favilla³

et al. 2015

CUAJ

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Introduction: Several prognostic models have been proposed to predict outcomes of patients affected by renal cell carcinoma. We analyze the discriminative capabilities of Karakiewicz, Kattan and Cindolo nomograms and perform a meta-analysis to yield pooled area under the receiver operator curves (AUCs) for model comparison. The end points of interest were disease-recurrence free survival (DFS) and cancer-specific survival (CSS). Methods: An electronic search of the Medline and Embase was undertaken until July 2014. The AUC value, total number of patients, number of disease recurrence, and cancer-related deaths were extracted from the included references. AUCs of the models were converted to odds ratios (ORs). For the meta-analysis, ln(OR) was used for data pooling. For each nomogram, the combined OR was transformed back to a converted AUC (cAUC). Conclusions:The predictive abilities of the pre-and postoperative Karakiewicz models are higher than Kattan or Cindolo in predicting DFS and CSS.

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A Review of Integrated Staging Systems for Renal Cell Carcinoma

Cited by 99 publications

References 78 publications

Prognostic Value of EZH2 Expression and Activity in Renal Cell Carcinoma: A Prospective Study

Prognostic Value of EZH2 Expression and Activity in Renal Cell Carcinoma: A Prospective Study

High plasma fibrinogen level represents an independent negative prognostic factor regarding cancer-specific, metastasis-free, as well as overall survival in a European cohort of non-metastatic renal cell carcinoma patients

Accuracy capabilities comparisons between Karakiewicz, Kattan and Cindolo nomograms in predicting outcomes for renal cancer carcinoma: A systematic review and meta-analysis

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