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Prognostic factors and prognostic models for renal cell carcinoma: a literature review

  • Tobias Klatte
  • Sabrina H. Rossi
  • Grant D. Stewart
Invited Review

Abstract

Purpose

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.

Methods

We performed a literature review on the current evidence based on prognostic factors and models for localised and metastatic RCC.

Results

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.

Conclusion

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.

Keywords

Renal cancer Prognosis Predictive Markers Biomarkers 

Notes

Author contributions

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.

Informed consent

For this type of study (review), formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyAddenbrooke’s HospitalCambridgeUK
  2. 2.Department of UrologyRoyal Bournemouth and Christchurch HospitalsBournemouthUK
  3. 3.Academic Urology Group, Department of SurgeryUniversity of CambridgeCambridgeUK

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