局灶性和局部晚期肾细胞癌的术前预后模型：关东日本泌尿肿瘤研究组。
Preoperative prognostic model for localized and locally advanced renal cell carcinoma: Michinoku Japan Urological Cancer Study Group.
发表日期：2023 Sep 22
作者：
Shigemitsu Horie, Sei Naito, Shingo Hatakeyama, Shuya Kandori, Kazuyuki Numakura, Renpei Kato, Tomoyuki Koguchi, Shingo Myoen, Yoshihide Kawasaki, Akihiro Ito, Hisanobu Adachi, Yoshiyuki Kojima, Wataru Obara, Tomonori Habuchi, Hiroyuki Nishiyama, Chikara Ohyama, Norihiko Tsuchiya
来源：
Disease Models & Mechanisms
摘要：
经实证验证的适用于局部和局部晚期肾细胞癌（LLRCC）的新修饰国际转移性肾细胞癌数据集联合模型（mIMDC）是一种术前预后模型。本研究旨在验证该mIMDC模型，并在LLRCC中构建一个新模型。我们建立了一个数据库（Michinoku日本泌尿系统癌症研究小组数据库），其中包括79例临床诊断为LLRCC（cT3b/c/4NanyM0）并接受根治性肾切除术的患者，时间为2007年12月至2018年5月。通过单变量和多变量分析，在该数据库中回顾性分析了无病生存（DFS）和总生存（OS），根据这些结果构建了一个新的预后模型，并使用新的和mIMDC模型的c-index估计了模型的拟合能力。DFS和OS的独立不良预后因素包括以下因素：≥1个东方合作组织肿瘤学小组工作能力状态、2.0mg/dL的C-反应蛋白和白细胞计数的上限超过正常值。有利（无因素），中等（一个因素）和不良风险组（两个或三个因素）的中位DFS分别为76.1、14.3和4.0个月（P＜0.001）。有利、中等和不良风险组的3年OS分别为92％、44％和0％（P＜0.001）。新的和mIMDC模型的DFS c指数分别为0.67和0.60（P=0.060），OS c指数分别为0.74和0.63（P=0.012）。LLRCC中的新术前预后模型可用于患者护理和临床试验。
©2023. 本文作者授予日本临床肿瘤学协会独家许可。
The Modified International Metastatic Renal Cell Carcinoma Dataset Consortium model (mIMDC) is a preoperative prognostic model for pT3cN0M0 renal cell carcinoma (RCC). This study aimed to validate the mIMDC and to construct a new model in a localized and locally advanced RCC (LLRCC).A database was established (the Michinoku Japan Urological Cancer Study Group database) consisting of 79 patients who were clinically diagnosed with LLRCC (cT3b/c/4NanyM0) and underwent radical nephrectomy from December 2007 to May 2018. Using univariable and multivariable analyses, we retrospectively analyzed disease-free survival (DFS) and overall survival (OS) in this database, constructed a new prognostic model according to these results, and estimated the model fit using c-index on the new and mIMDC models.Independent poorer prognostic factors for both DFS and OS include the following: ≥ 1 Eastern Cooperative Oncology Group performance status, 2.0 mg/dL C-reactive protein, and > upper normal limit of white blood cell count. The median DFS in the favorable (no factor), intermediate (one factor), and poor-risk group (two or three factors) was 76.1, 14.3, and 4.0 months, respectively (P < 0.001). The 3-year OS in the favorable, intermediate, and poor-risk group were 92%, 44%, and 0%, respectively (P < 0.001). The c-indices of the new and mIMDC models were 0.67 and 0.60 for DFS (P = 0.060) and 0.74 and 0.63 for OS (P = 0.012), respectively.The new preoperative prognostic model in LLRCC can be used in patient care and clinical trials.© 2023. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.