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A combined postoperative nomogram for survival prediction in clear cell renal carcinoma

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To investigate and validate the prognostic value of nomogram models for predicting disease-free survival (DFS) and overall survival (OS) in patients with clear cell renal cell carcinoma (ccRCC).

Methods

In this retrospective study, 223 patients (age 54.38 ± 10.93 years) with pathologically confirmed ccRCC who underwent resection and lymph node dissection between March 2010 and September 2018 were investigated. All patients were randomly divided into training (n = 155) and validation (n = 68) cohorts. Radiomics features were extracted from computed tomography (CT) images in the unenhanced, corticomedullary, and nephrographic phases. Radiomic score was calculated and combined with clinicopathological factors for model construction and nomogram development. Clinicopathological factors and imaging features were collected at initial diagnosis. Univariate and multivariate Cox proportional hazards regression analyses were used to evaluate the relationship between the radiomics signature and prognosis outcomes.

Results

There were four prognostic factors for predicting DFS and five factors for predicting OS in our nomogram model (P < 0.05). The radiomics signature correlated independently with DFS (hazard ratio = 27; P < 0.001) and OS (hazard ratio = 25; P < 0.001). The nomogram showed excellent performance (C-index = 0.825) for predicting DFS. The combined nomogram also showed the highest C-index for OS (C-index = 0.943), which was verified in the validation dataset.

Conclusion

The combined nomogram model based on radiomics, clinicopathological factors, and preoperative CT features can accurately perform prognosis and survival analysis and can potentially be used for preoperative non-invasive survival prediction in ccRCC patients.

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Data availability

The datasets generated/analyzed in this article are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Editage (www.editage.com) for the English language editing service.

Funding

This work was supported by the Natural Science Foundation of Shandong [Grant Number NO. ZR2020MH289] and the Academic promotion program of Shandong First Medical University [Grant Number 2019QL023].

Author information

Author notes

  1. Ying Ming and Xinyi Chen have contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, Huaiyin District, Jinan, 250012, Shandong, China

    Ying Ming, Jie Zhang, Teng Ma, Zhiling Liu & Zhaoqin Huang

  2. Department of Nuclear Medicine, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, 210018, China

    Xinyi Chen

  3. Department of Research Collaboration, R&D center, Beijing Deepwise & League of PHD Technology Co. Ltd, Beijing, 100080, China

    Jingxu Xu & Chencui Huang

  4. Department of Radiology, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, Shandong, China

    Haiyu Zhan

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by YM, XC, HZ, and JX. The first draft of the manuscript was written by Ying Ming and all authors read and approved the final manuscript. Conceptualization: ZH and JZ; Methodology: YM, HZ, and TM; Formal analysis and investigation: YM and XC; Software: JX and CH; Validation: JX; Visualization: YM, XC, and ZL; Writing—original draft preparation: YM; Writing—review and editing: XC, JZ, and ZH; Supervision: ZH.

Corresponding author

Correspondence to Zhaoqin Huang.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

The study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Shandong Provincial Hospital (Date2021-07-07/ No. 2021-257).

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The requirement for informed consent was waived due to the retrospective nature of the study.

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Ming, Y., Chen, X., Xu, J. et al. A combined postoperative nomogram for survival prediction in clear cell renal carcinoma. Abdom Radiol 47, 297–309 (2022). https://doi.org/10.1007/s00261-021-03293-4

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