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Prognostic nomogram for patients with lung metastatic renal cell carcinoma: a SEER-based study
Weipu Mao1, Zhenrui Fu2, Keyi Wang3
1Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China; Surgical Research Center, Institute of Urology, Southeast University Medical School, Nanjing, China; Department of Urology, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China.
Background:
Our study aimed to establish a clinically practical and reliable prognostic nomogram based on the important prognostic factors to predict the prognosis of patients with lung metastatic renal cell carcinoma (RCC).
Methods:
Clinical data of patients with lung metastatic RCC between 2010 and 2015 were collected from the SEER database. Prognostic nomogram was established using R software to predict the OS and CSS probability for individual patients. Consistency index (C-index), calibration curve and decision curve analysis (DCA) were used to assess the predictive performance of the nomogram, and to calibrated the nomogram for 1-, 2-, and 3-year cancer-specific survival (CSS) and overall survival (OS).
Results:
1,563 patients were enrolled in this study. All patients were randomly divided into the primary cohort (937) and the validation cohort (626). Multivariate Cox regression showed that age, histology, N-stage, T-stage, surgery and radiotherapy were independent risk factor of OS, and histology, N-stage, T-stage, surgery were CSS related factors in patients with lung metastatic RCC in the primary cohort. The C-index of the nomogram OS was 0.662 and the C-index of CSS was 0.658 in the primary cohort. In the validation cohort, the C-index of the nomogram CSS and OS were 0.685 and 0.694, respectively. Moreover, the calibration curves showed good consistency between nomogram predictions and actual 1-, 2-, and 3-year OS and CSS rates in the primary and external verification cohorts.
Conclusions:
The prognostic nomogram constructed in this study can provide an individualized treatment and risk assessment for survival in patients with lung metastatic RCC.
