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Kattan postoperative nomogram for renal cell carcinoma: Predictive accuracy in a Japanese population
Author(s) -
Suzuki Kazuya,
Nishiyama Tsutomu,
Hara Noboru,
Akazawa Kohei,
Takahashi Kota
Publication year - 2011
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2010.02693.x
Subject(s) - nomogram , medicine , renal cell carcinoma , confidence interval , concordance , stage (stratigraphy) , nephrectomy , multivariate analysis , univariate , population , hazard ratio , proportional hazards model , univariate analysis , urology , oncology , multivariate statistics , kidney , statistics , mathematics , paleontology , environmental health , biology
Objectives: The aim of the current study was to establish the predictive accuracy of the Kattan postoperative nomogram for non‐metastatic renal cell carcinoma (RCC) in a Japanese population. Methods: A total of 211 patients with stage T1–3N0M0 clear cell RCC who underwent radical nephrectomy or nephron‐sparing surgery between 1991 and 2004 were included in this analysis. Median follow up was 81 months (range: 4–208). Univariate and multivariate analyses were performed, and the influence of age, sex, clinical presentation, T stage, histological tumor size, grade, and microvascular invasion on disease recurrence‐free survival (RFS) was determined. For each patient, the prognostic score for 5‐year RFS was calculated using the Kattan nomogram. The discriminating ability of this model was assessed by the concordance index, and bootstrapping was used to evaluate confidence intervals. Results: The 5‐year RFS rate for all patients calculated using the Kaplan–Meier method was 80.6%. In multivariate analysis, the statistically significant prognostic factors for 5‐year RFS were high‐grade tumors ( P = 0.019) and symptomatic disease ( P = 0.017). The concordance index for RFS predicted by the Kattan nomogram was 0.735 (95% confidence interval: 0.734–0.736). There was a slight discrepancy between the RFS predicted by the Kattan nomogram and the likelihood of being recurrence‐free at 5 years according to the Cox analysis in the current patient population. Conclusion: These findings suggest the necessity of constructing a more useful nomogram for predicting the prognosis of Japanese patients with non‐metastatic RCC.