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In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
Published on: March 30, 2015
A nomogram based on contrast-enhanced computed tomography (CT)-derived extracellular volume fraction to predict
1Department of Graduate, Bengbu Medical University, Bengbu, Anhui 233030, China.
Aim:
This study aims to develop a nomogram incorporating the extracellular volume (ECV) fraction, the Mayo Clinic stage, size, grade, necrosis score (SSIGN score), and clinical prognostic factors (CPFs) to predict disease-free survival (DFS) in postoperative patients with clear cell renal cell carcinoma (ccRCC).
Materials And Methods:
This retrospective study included 220 ccRCC patients from February 2019 to December 2021. ECV fraction was measured using preoperative contrast-enhanced computed tomography equilibrium images. Clinical data-age, gender, surgical approach, systemic immune-inflammation index (SII), prognostic nutritional index, the SSIGN score, and the Mayo Adhesive Probability score-were collected. Tumour size, grade, and stage were obtained from postoperative pathology. Independent prognostic factors for DFS were identified using univariable and multivariable Cox regression analyses. Kaplan-Meier curves and log-rank tests were used for survival analysis. The nomogram's performance was evaluated by receiver operating characteristic curves, concordance index (C-index), calibration curves, and decision curve analysis (DCA).
Results:
Multivariable Cox regression identified ECV fraction [hazard ratio (HR): 2.625, P = 0.002], SII [HR: 4.523, P < 0.001], World Health Organization/International Society of Urological Pathology grade (WHO/ISUP grade) [HR: 2.351, P = 0.009], tumor stage (P < 0.05), and SSIGN score (P < 0.05) as independent predictors of DFS in ccRCC patients. The nomogram integrating ECV fraction, SSIGN score, and CPFs showed good discrimination (C-index = 0.736), with AUCs of 0.840 and 0.787 for 2- and 3-year DFS, respectively. DCA demonstrated favourable clinical utility, and calibration curves showed close agreement between predicted and observed DFS.
Conclusion:
The nomogram incorporating ECV fraction, SSIGN score, and CPFs effectively predicts postoperative DFS in ccRCC patients, offering a valuable tool for individualised treatment planning.
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