Development and validation of nomogram based on a novel platelet index score to predict prognosis in patients with renal cell carcinoma

Abstract

Purpose: This study aims to develop and validate a nomogram based on a novel platelet index score (PIS) to predict prognosis in patients with renal cell carcinoma (RCC). Patients and methods: We retrospectively analyzed the data of 759 consecutive patients with RCC. The Kaplan-Meier curves were performed to analyze the platelet parameters and PIS was established. The patients were randomly divided into training (N=456, 60%) and validation cohorts (N=303, 40%). The nomogram was created based on the factors determined by multivariable Cox proportional hazard regression of the training cohort. We assessed the discrimination and calibration of our nomogram in both training and validation cohorts. And then the nomogram was compared with other reported models. Results: High platelet count (PLT>285×10 9 /L) and low platelet distribution width (PDW≤10.95fL) were associated with shorter progression-free survival (PFS). Thus, PLT and PDW were incorporated in a novel score system called PIS. On multivariable analysis of training cohort, PIS, American Joint Committee on Cancer (AJCC) stage, and sarcomatoid differentiation were independent prognostic factors, which were all selected into the nomogram. The nomogram exhibited good discrimination in both training (C-index: 0.835) and validation cohorts (C-index: 0.883). The calibration curves also showed good agreement between prediction and observation in both cohorts. The C-index of the nomogram (C-index: 0.810~0.902) for predicting 2-year, 3-year, and 4-year PFS were significantly higher than Leibovich (C-index: 0.772~0.813), SSIGN (C-index: 0.775~0.876), Cindolo (C-index: 0.642~0.798), Yaycioglu (C-index: 0.648~0.804), MSKCC (C-index: 0.761~0.862), Karakiewicz (C-index: 0.747~0.851), and AJCC stage models (C-index: 0.759~0.864). Conclusion:The nomogram based on a novel PIS could offer better risk stratification in patients with RCC.

Clinical significance of prognostic nutritional index (PNI)-monocyte-to-lymphocyte ratio (MLR)-platelet (PLT) score on postoperative outcomes in non-metastatic clear cell renal cell carcinoma

“…In addition, tumor cells promote the production and release of platelets by activating the IL-6, and excessive platelets increase the risk of vascular embolism in cancer patients [ 23 ]. The platelet vice versa promote tumor growth and invasion by releasing cytokines such as vascular endothelial growth factor (VEGF), platelet derived growth factor (PDGF) and transforming growth factor-β (TGF-β) [ 12 , 23 ].…”

Prognostic and Clinicopathological Correlations of Pretreatment Prognostic Nutritional Index in Renal Cell Carcinoma: A Meta-Analysis

“…Fifth, the HRs extracted from the survival curve and univariate analysis may be not accurate as a matter of fact. Sixth, other than PNI, there are also other scores that are just as easy to use for prognosis prediction of RCC patients (e.g., Glasgow Prognostic Score [52][53][54], systemic immune-inflammation index [55], albumin-globulin score [56], platelet index score [57], et al). It may be necessary to determine which prognostic factor may be more accuracy [39] or whether different score systems should be integrated [56,58].…”

Development and validation of a nomogram model for individualized prediction of hypertension risk in patients with type 2 diabetes mellitus

“…The bootstrap method was used to internally verify the nomogram model 1000 times, and the concordance index (C-index) was computed to assess the discrimination of the nomogram model. C-index0.50–0.70 was the low precision, 0.71–0.90 was the average quasi-accuracy 21 , and above 0.90 was the high precision. Consistency was tested by plotting the calibration curves between the predicted and actual results.…”