准确预测肾细胞癌 (RCC) 患者癌症控制结局在咨询、后续规划和选择适当的辅助试验设计中至关重要。我们旨在开发和外部验证一种新的基于当代人口的模型，用于预测手术治疗乳头状肾细胞癌 (papRCC) 患者的癌症特异性死亡无病生存率 (CSM-FS)，并将其与已建立的风险类别 (Leibovich 2018) 进行比较。在监测、流行病学和终点数据数据库 (2004-2019) 中，我们确定了接受手术治疗的 papRCC 患者 (n = 3978)。人口随机分为开发组 (50%，n = 1989) 和外部验证组 (50%，n = 1989)。在外部验证队列中，其中97% (n = 1930) 的患者被纳入比较不转移患者的 Leibovich 2018 风险类别的头对头比较。单变量 Cox 回归模型测试了对 CSM-FS 的统计学显著性预测。选择具有最佳验证指标的最简单模型作为多变量计分表。准确度、校准度和决策曲线分析 (DCAs) 测试了 Cox 回归计算的计分表，以及外部评估组中的 Leibovich 2018 风险类别。诊断时年龄、分级、 T 分期、N 分期和 M 分期合格纳入新计分表。在外部验证中，新计分表在 5 年和 10 年的准确度分别为 0.83 和 0.80。在非转移性患者中，新计分表的 5 年和 10 年准确度分别为 0.77 和 0.76，而 Leibovich 2018 风险类别的 5 年和 10 年准确度分别为 0.70 和 0.66。与 Leibovich 2018 风险类别相比，新计分表在校准图中偏离理想预测更小，在 DCAs 中表现出更高的净收益。局限性包括研究的回顾性性质，没有中央病理学评审和仅包括北美患者。在 papRCC CSM-FS 预测需要时，新计分表可能代表一种有价值的临床辅助工具。我们在北美人群中开发了一种准确预测乳头肾癌死亡的工具。版权所有©2023年欧洲泌尿科协会。保留所有权利。

Accurate prediction of cancer control outcomes in renal cell carcinoma (RCC) patients is important for counselling, follow-up planning, and selection of appropriate adjuvant trial designs.To develop and externally validate a novel contemporary population-based model for predicting cancer-specific mortality-free survival (CSM-FS) in surgically treated papillary RCC (papRCC) patients and to compare it with established risk categories (Leibovich 2018).Within the Surveillance, Epidemiology, and End Results database (2004-2019), we identified surgically treated papRCC patients (n = 3978). The population was randomly divided into development (50%, n = 1989) and external validation (50%, n = 1989) cohorts. Of the external validation cohort, 97% (n = 1930) of patients were included in a head-to-head comparison of the Leibovich 2018 risk categories addressing nonmetastatic patients.Univariable Cox regression models tested the statistical significance in the prediction of CSM-FS. The most parsimonious model with the best validation metrics was selected as the multivariable nomogram. Accuracy, calibration, and decision curve analyses (DCAs) tested the Cox regression-based nomogram, as well as the Leibovich 2018 risk categories in the external validation cohort.Age at diagnosis, grade, T stage, N stage, and M stage qualified for inclusion in the novel nomogram. In external validation, the accuracy of the novel nomogram was 0.83 at 5 yr and 0.80 at 10 yr. In nonmetastatic patients, 5- and 10-yr accuracy of the novel nomogram was 0.77 and 0.76, respectively. Conversely, 5- and 10-yr accuracy of the Leibovich 2018 risk categories was 0.70 and 0.66, respectively. The novel nomogram exhibited smaller departures from ideal predictions in calibration plots and higher net benefit in DCAs, when it was compared with the Leibovich 2018 risk categories. Limitations include the retrospective nature of the study, absence of a central pathological review, and inclusion of only North American patients.The novel nomogram may represent a valuable clinical aid, when papRCC CSM-FS predictions are required.We developed an accurate tool to predict death due to papillary kidney cancer in a North American population.Copyright © 2023 European Association of Urology. All rights reserved.