External validation of the Mayo Clinic cancer specific survival score in a Japanese series of clear cell renal cell carcinoma
External validation of the Mayo Clinic cancer specific survival score in a Japanese series of clear cell renal cell carcinoma
复制标题
DOI：
10.1016/j.juro.2008.06.014
复制
发表时间：
2008-10-01
影响因子：
6.6
通讯作者：
Kihara, Kazunori
中科院分区：
文献类型：
--
作者：
Fujii, Yasuhisa;Saito, Kazutaka;Kihara, Kazunori
目的：我们在独立的日本患者样本中验证了马约诊所SSIGN（分期、大小、等级和坏死）评分。材料和方法：1985年至2006年间，连续406名日本患者因肾透明细胞癌接受了肾切除术。采用考克斯比例风险回归模型评估病理特征对疾病特异性生存期的预后价值。结果：406例患者中位随访时间为56个月。100例死于肾癌，5年生存率为78.4%。单因素分析显示，SSIGN评分的所有特征与肾细胞癌死亡显著相关。原发肿瘤分类、区域淋巴结转移、远处转移和Fuhrman核分级与肾细胞癌死亡率在多变量环境中显著相关。406例患者的中位SSGN评分为3分（范围0 - 15分）。SSGN评分的一致性指数为0.814。评分0 ~ 2、3 ~ 4、5 ~ 6、7 ~ 9、10分以上者5年生存率分别为96.8%、92.5%、78.8%、57.7%、18.1%。后3组的生存率高于美国和欧洲patients.Conclusions报告率：马约诊所SSIGN评分可适用于日本肾细胞癌患者具有高度的预后准确性。未来的研究需要确定日本中度和高度SSGN评分的患者是否比美国和欧洲的患者生存更长。
Purpose: We validated the Mayo Clinic SSIGN (stage, size, grade and necrosis) score in an independent Japanese sample of patients.Materials and Methods: Between 1985 and 2006, 406 consecutive Japanese patients underwent nephrectomy for clear cell renal cell carcinoma. The prognostic value of pathological features for disease specific survival was evaluated using the Cox proportional hazards regression model. The predictive ability of the SSIGN score was evaluated using the concordance index.Results: Median followup in the 406 patients was 56 months. Of the patients 100 died of renal cell carcinoma and the 5-year cancer specific survival rate was 78.4%. All features comprising the SSIGN score were significantly associated with death from renal cell carcinoma on univariate analysis. Primary tumor classification, regional lymph node involvement, distant metastasis and Fuhrman nuclear grade were significantly associated with death from renal cell carcinoma in a multivariate setting. The median SSIGN score in the 406 patients was 3 (range 0 to 15). The concordance index of the SSIGN score was 0.814. The 5-year cancer specific survival rate in patients with a score of 0 to 2, 3 or 4, 5 or 6, 7 to 9 and 10 or more was 96.8%, 92.5%, 78.8%, 57.7% and 18.1%, respectively. The survival rate in the latter 3 groups was higher than reported rates in American and European patients.Conclusions: The Mayo Clinic SSIGN score can be applicable to Japanese patients with renal cell carcinoma with a high degree of prognostic accuracy. Future studies are needed to determine whether Japanese patients with moderate and high SSIGN scores survive longer than their American and European counterparts.