Prognostic factors and prognostic models for renal cell carcinoma: a literature review
- 499 Downloads
Following curative treatment for localised renal cell carcinoma (RCC), up to 30% of patients develop tumour recurrence. Prognostic scores are essential to guide individualised surveillance protocols, patient counselling and potentially in the future to guide adjuvant therapy. In metastatic RCC, prognostic scores are routinely used for treatment selection in clinical practice as well as in all major trials.
We performed a literature review on the current evidence based on prognostic factors and models for localised and metastatic RCC.
A number of prognostic factors have been identified, of which tumour node metastasis classification remains the most important. Multiple prognostic models and nomograms have been developed for localised disease, based on a combination of tumour stage, grade, subtype, clinical features, and performance status. However, there is poor level of evidence for their routine use. Prognostic scores for patients with metastatic RCC receiving targeted treatments are used routinely, but have limited accuracy. Molecular markers can improve the accuracy of established prognostic models, but frequently lack external, independent validation.
Several factors and models predict prognosis of localised and metastatic RCC. They represent valuable tools to provide estimates of clinically important endpoints, but their accuracy should be improved further. Validation of molecular markers is a future research priority.
KeywordsRenal cancer Prognosis Predictive Markers Biomarkers
TK: project development, data collection, data analysis, manuscript writing and editing. SHR: data analysis, manuscript editing. GDS: project development, data analysis, manuscript editing, supervision.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no relevant conflicts of interest.
Research involving human participants and/or animals
The following manuscript is a review of existing data. Therefore, this article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study (review), formal consent is not required.
- 14.Ljungberg B, Albiges L, Bensalah K, et al (2018) EAU guidelines on renal cell carcinoma. http://uroweb.org/guideline/renal-cell-carcinoma/. Accessed 1 Apr 2018
- 24.Delahunt B, Eble JN (1997) Papillary renal cell carcinoma: a clinicopathologic and immunohistochemical study of 105 tumors. Mod Pathol Off J US Can Acad Pathol Inc 10:537–544Google Scholar
- 46.George DJ, Martini J-F, Staehler M et al (2018) Immune biomarkers predictive for disease-free survival with adjuvant sunitinib in high-risk locoregional renal cell carcinoma: from randomized phase III S-TRAC study. Clin Cancer Res Off J Am Assoc Cancer Res. https://doi.org/10.1158/1078-0432.CCR-17-2822 CrossRefGoogle Scholar
- 71.Ko JJ, Xie W, Kroeger N et al (2015) The International Metastatic Renal Cell Carcinoma Database Consortium model as a prognostic tool in patients with metastatic renal cell carcinoma previously treated with first-line targeted therapy: a population-based study. Lancet Oncol 16:293–300. https://doi.org/10.1016/S1470-2045(14)71222-7 CrossRefPubMedGoogle Scholar
- 80.Battle C, Abbott Z, Hutchings HA et al (2017) Protocol for a multicentre randomised feasibility STUdy evaluating the impact of a prognostic model for management of BLunt chest wall trauma patients: STUMBL trial. BMJ Open 7:e015972. https://doi.org/10.1136/bmjopen-2017-015972 CrossRefPubMedPubMedCentralGoogle Scholar