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External validation of a postoperative nomogram for the prediction of disease-specific survival in patients with papillary renal cell carcinoma using a large multicenter database

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Abstract

Purpose

Based on data retrieved from a comprehensive multicenter database, we externally validated a published postoperative nomogram for the prediction of disease-specific survival (DSS) in patients with papillary renal cell carcinoma (papRCC).

Methods

A multicenter database containing data of 2325 patients with surgically treated papRCC was used as validation cohort. After exclusion of patients with missing data and patients included in the development cohort, 1372 patients were included in the final analysis. DSS-probabilities according to the nomogram were calculated and compared to actual DSS-probabilities. Subsequently, calibration plots and decision curve analyses were applied.

Results

The median follow-up was 38 months (IQR 11.8–80.7). Median DSS was not reached. The c-index of the nomogram was 0.71 (95% CI 0.60–0.83). A sensitivity analysis including only patients operated after 1998 delivered a c-index of 0.84 (95% CI 0.77–0.92). Calibration plots showed slight underestimation of nomogram-predicted DSS in probability ranges below 90%: median nomogram-predicted 5-year DSS in the range below 90% was 55% (IQR 20–80), but the median actual 5-year DSS in the same group was 58% (95% CI 52–65). Decision-curve analysis showed a positive net-benefit for probability ranges between a DSS probability of 5% and 85%.

Conclusions

The nomogram performance was satisfactory for almost all DSS probabilities; hence it can be recommended for application in clinical routine and for counseling of patients with papRCC.

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Acknowledgements

We thank Wilma Erhardt, M.Sc. for the statistical review and support of this work.

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Authors and Affiliations

  1. Department of Urology, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany

    Stefan Zastrow & Manfred Wirth

  2. Department of Urology, University Hospital Muenster, Muenster, Germany

    Laura-Maria Krabbe

  3. Department of Urology, University Hospital Greifswald, Greifswald, Germany

    Ingmar Wolff

  4. Department of Urology, San Raffaele Scientific Institute, Milan, Italy

    Umberto Capitanio

  5. Division of Experimental Oncology/Unit of Urology, URI, IRCCS San Raffaele Hospital, Milan, Italy

    Umberto Capitanio

  6. Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK

    Tobias Klatte

  7. Department of Urology, Hospital Bad Saarow, Bad Saarow, Germany

    Thorsten Ecke

  8. Department of Urology, University Hospital Mannheim, Mannheim, Germany

    Nina Huck

  9. Department of Urology, University Hospital Mainz, Mainz, Germany

    Hendrik Borgmann

  10. Department of Urology, Instituto Nacional de Cancerologia-INCan, Mexico City, Mexico

    Anna Scavuzzo

  11. Department of Urology, ASL Abruzzo2, “S. Pio da Pietrelcina” Hospital, Vasto, Italy

    Luca Cindolo

  12. Department of Urology, ASL Abruzzo2, Chieti, Italy

    Luigi Schips

  13. Centre of Urological Surgery, Dialysis and Renal Transplantation, Fundeni Clinical Institute, Bucharest, Romania

    Cristian Surcel & Cristian Mirvald

  14. Hospital Clínic, University of Barcelona, Barcelona, Spain

    Antoni Vilaseca Cabo & Mireia Musquera

  15. Department of Urology, Medical University of Graz, Graz, Austria

    Georg Hutterer

  16. Department of Urology, Faculty of Medicine, Charles University, Pilsen, Czech Republic

    Kristyna Prochazkova

  17. Department of Urology, LMU Munich, Grosshadern, Munich, Germany

    Christian Stief & Sabine Brookman-May

  18. Department of Urology, Klinikum St. Elisabeth, Straubing, Germany

    Matthias May

  19. Department of Urology, Elblandklinikum Riesa, Weinbergstrasse 8, 01589, Riesa, Germany

    Stefan Zastrow & Manfred Wirth

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  1. Stefan Zastrow
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Corresponding author

Correspondence to Stefan Zastrow.

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Conflict of interest

Stefan Zastrow declares that there are no conflicts of interest. Laura-Maria Krabbe declares that there are no conflicts of interest. Ingmar Wolff declares that there are no conflicts of interest. Umberto Capitanio declares that there are no conflicts of interest. Tobias Klatte declares that there are no conflicts of interest. Thorsten Ecke declares that there are no conflicts of interest. Nina Huck declares that there are no conflicts of interest. Hendrik Borgmann declares that there are no conflicts of interest. Anna Scavuzzo declares that there are no conflicts of interest. Luca Cindolo declares that there are no conflicts of interest. Luigi Schips declares that there are no conflicts of interest. Cristian Surcel declares that there are no conflicts of interest. Cristian Mirvald declares that there are no conflicts of interest. Antoni Vilaseca Cabo declares that there are no conflicts of interest. Mireia Musquera declares that there are no conflicts of interest. Georg Hutterer declares that there are no conflicts of interest. Kristyna Prochazkova declares that there are no conflicts of interest. Christian Stief declares that there are no conflicts of interest. Manfred Wirth declares that there are no conflicts of interest. Matthias May declares that there are no conflicts of interest. Sabine Brookman-May declares that there are no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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10147_2019_1530_MOESM1_ESM.xlsx

Supplementary Appendix, Table 2: Comparison of available tumor characteristics between excluded patients and patients within the validation cohort 1 (XLSX 9 kb)

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Zastrow, S., Krabbe, LM., Wolff, I. et al. External validation of a postoperative nomogram for the prediction of disease-specific survival in patients with papillary renal cell carcinoma using a large multicenter database. Int J Clin Oncol 25, 145–150 (2020). https://doi.org/10.1007/s10147-019-01530-x

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  • DOI: https://doi.org/10.1007/s10147-019-01530-x

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