San Diego, CA USA (UroToday.com) Patients with cortical renal masses (CRM) are presented with multiple treatment options, including radical nephrectomy (RN), partial nephrectomy (PN), ablation or active surveillance (AS). The clinical tools available to assess individual risk of oncologic outcomes are limited.
Dr. Psutka and colleagues aim to construct a comprehensive nomogram to estimate a 5-year cancer-specific mortality (CSM), 5-year other-cause mortality (OCM), as well as Clavien 3-5 complications (within 90-days), following treatment modalities for localized renal cell carcinoma (RCC).
In this retrospective study, the multi-institutional cohort looked at 3079 patients with localized RCC from 2000-2010, at two academic centers. They used random forest algorithms for competing risks to identify variables for the final three multivariable models. For 5-year CSM, the predicted probability for patients receiving RN, PN, ablation and AS are 12.5%, 14%, 8% and 28% respectively. For 5-year OCM, the predicted probability was 20%, 18%, 24% and 23%, respectively. Lastly, for 90-day Clavien 3-5 complications, the predicted probability for patients receiving RN, PN and ablation were 1.5%, 2.5%, and 7%, respectively.
The authors conclude that these nomograms can facilitate an easier approach to patient counseling and provide patients with estimated individualized probabilities based on basic preoperative information. At this time, they are pending external validation, and their next steps are to work with more institutions.
Presented By: Sarah Psutka, MD
Written By: Victor Huynh, CCRP, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA