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Updated: Jun 17, 2026
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Contemporary Validation of the Renal Cell Carcinoma Inflammatory Score for Preoperative Prognostication in
Adam Braunschweig1, Gabriel Ekene Agu1, Reza Lahiji1
1Department of Urology, Emory University School of Medicine, Atlanta, Georgia.
Introduction:
The Renal Cell Carcinoma Inflammatory Score (RISK) is a preoperative prognostic model incorporating easily accessible inflammatory markers. This study validates the prognostic value of the RISK score and compares Renal Cell Carcinoma (RCC) prognostic models in a nonmetastatic RCC cohort.
Methods:
Following Institutional Review Board approval, patients from Emory's Nephrectomy Database undergoing nephrectomy for nonmetastatic RCC between 2007 and 2024 were included. RISK scores were calculated using C-reactive protein, albumin, erythrocyte sedimentation rate, aspartate aminotransferase, alanine aminotransferase, and corrected calcium. Scores were classified as baseline (0), low (1-3), intermediate (4-6), and high (7-10) risk. Overall survival (OS) and disease-free survival (DFS) were analyzed using Cox proportional hazards models. Time-dependent AUC analyses compared RISK against Stage, Size, Grade and Necrosis, University of California Los Angeles Integrated Staging System, and Mayo progression free survival (PFS) models at 1, 3, 5, and 10 years.
Results:
A total of 1056 patients were included. Increasing RISK categories were independently associated with worse DFS and OS. Compared with no/baseline-risk patients, high-risk patients had worse DFS (HR 3.38, 95% CI 1.82-6.29, P < .001) and OS (HR 2.54, 95% CI 1.28-5.03, P = .007). For DFS and OS, RISK demonstrated comparable discrimination against Stage, Size, Grade and Necrosis, University of California Los Angeles Integrated Staging System, and Mayo PFS. The combination of the RISK model with the Mayo PFS model resulted in superior DFS AUC at 5 and 10 years postoperatively compared with Mayo PFS alone.
Conclusions:
Elevated RISK groups were independently associated with poor DFS and OS among patients with nonmetastatic RCC, demonstrating discrimination comparable with established models. Pending validation, the addition of RISK to existing models may enhance prognostication and counselling.