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Can the Kattan nomogram still accurately predict prognosis in renal cell carcinoma using the revised 2010 tumor-nodes-metastasis reclassification?

Lookup NU author(s): Dr Amira El-Sherif, Dr Mark Johnson, Professor Naeem Soomro, Professor Rakesh Heer

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Abstract

The Kattan nomogram has been used in renal cell cancer to predict progression-free survival after nephrectomy. Tumornodesmetastasis staging is essential for the calculation of this score. The effect of the recent 2010 revision to the tumornodesmetastasis classification on the predictive ability of the Kattan nomogram was studied. All patients having radical nephrectomy for renal cell cancer in the 5-year period of 20042008 at a tertiary referral center were included. Pathological and radiological records were reviewed to identify tumornodesmetastasis stage (2002 and 2010 classifications). Kattan scores were calculated for the 2002 and 2010 tumornodesmetastasis stages, and the effect on survival predictions were compared with actual outcomes. A total of 291 patients with non-metastatic renal cell cancer were identified. Revision of the tumornodesmetastasis staging from the 2002 to 2010 classification resulted in an increase in the number of patients with stage pT3a (from 30 to 75), a reduction in the patients with stage pT3b (from 57 to 10) and a small increase in stage pT4 cases (1 to 3). This altered the proportion of patients in the Kattan prognostic of good (from 61% to 69%), intermediate (from 29% to 22%) and poor (from 10% to 8%). The overall median predicted 5-year progression-free survival was 79.8% with 2002 tumornodesmetastasis, and 81.8% with 2010 tumornodesmetastasis. Actual 5-year progression-free survival was 83.0%, which was not significantly different from that predicted using either tumornodesmetastasis classification (P = 0.66). On comparing the new 2010 and old 2002 tumornodesmetastasis classification in our cohort, we showed the predictive ability of the Kattan nomogram remained unaltered.

Publication metadata

Author(s): Veeratterapillay R, Rakhra S, El-Sherif A, Johnson M, Soomro N, Heer R

Publication type: Article

Publication status: Published

Journal: International Journal of Urology

Year: 2012

Volume: 19

Issue: 8

Pages: 773-776

Print publication date: 04/04/2012

ISSN (print): 0919-8172

ISSN (electronic): 1442-2042

Publisher: Wiley-Blackwell Publishing Asia

URL: http://dx.doi.org/10.1111/j.1442-2042.2012.03008.x

DOI: 10.1111/j.1442-2042.2012.03008.x

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