Risk of recurrence after nephrectomy: Comparison of predictive ability of validated risk models

Palumbo, Carlotta; Perri, Davide; Zacchero, M.; Bondonno, G.; Martino, J. Di; D’Agate, D.; Volpe, Alessandro

doi:10.1016/j.urolonc.2021.11.025

Cited by 4 publications

(1 citation statement)

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“…However, their ability to predict cancer-specific survival (CSS) has only been validated in a mono-institutional European cohort of 127 chRCC patients [ 16 ]. We assessed the ability of these prognostic models to predict CSS in a population-based North American cohort relying on the 2000–2019 Surveillance, Epidemiology, and End Results (SEER) database [ 21 , 22 ]. Moreover, we developed and externally validated a novel prognostic nomogram for individual prediction of CSS in chRCC patients.…”

Section: Introductionmentioning

confidence: 99%

Critical Appraisal of Leibovich 2018 and GRANT Models for Prediction of Cancer-Specific Survival in Non-Metastatic Chromophobe Renal Cell Carcinoma

Piccinelli

Morra

Tappero

et al. 2023

Cancers

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Within the Surveillance, Epidemiology, and End Results database (2000–2019), we identified 5522 unilateral surgically treated non-metastatic chromophobe kidney cancer (chRCC) patients. This population was randomly divided into development vs. external validation cohorts. In the development cohort, the original Leibovich 2018 and GRANT categories were applied to predict 5- and 10-year cancer-specific survival (CSS). Subsequently, a novel multivariable nomogram was developed. Accuracy, calibration and decision curve analyses (DCA) tested the Cox regression-based nomogram as well as the Leibovich 2018 and GRANT risk categories in the external validation cohort. The accuracy of the Leibovich 2018 and GRANT models was 0.65 and 0.64 at ten years, respectively. The novel prognostic nomogram had an accuracy of 0.78 at ten years. All models exhibited good calibration. In DCA, Leibovich 2018 outperformed the novel nomogram within selected ranges of threshold probabilities at ten years. Conversely, the novel nomogram outperformed Leibovich 2018 for other values of threshold probabilities. In summary, Leibovich 2018 and GRANT risk categories exhibited borderline low accuracy in predicting CSS in North American non-metastatic chRCC patients. Conversely, the novel nomogram exhibited higher accuracy. However, in DCA, all examined models exhibited limitations within specific threshold probability intervals. In consequence, all three examined models provide individual predictions that might be suboptimal and be affected by limitations determined by the natural history of chRCC, where few deaths occur within ten years from surgery. Further investigations regarding established and novel predictors of CSS and relying on large sample sizes with longer follow-up are needed to better stratify CSS in chRCC.

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Section: Introductionmentioning

confidence: 99%