Prognostic Value of the Leibovich Prognosis Score Supplemented by Vascular Invasion for Clear Cell Renal Cell Carcinoma
Prognostic Value of the Leibovich Prognosis Score Supplemented by Vascular Invasion for Clear Cell Renal Cell Carcinoma
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DOI：
10.1016/j.juro.2011.10.155
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发表时间：
2012-03-01
影响因子：
6.6
通讯作者：
Zigeuner, Richard
中科院分区：
文献类型：
--
作者：
Pichler, Martin;Hutterer, Georg C.;Zigeuner, Richard
目的：我们评估是否补充血管浸润的Leibovich预后评分将提高预后价值，以预测转移性疾病的患者与nonmetastatic透明细胞renal cell carcinoma.Materials和Methods：我们回顾性评价了1,754例非转移性透明细胞肾细胞癌患者的病理记录，1984年至2006年之间的手术治疗在一个单一的三级学术中心。Leibovich预后评分由血管浸润的额外评分补充。使用Kaplan-Meier方法评估每个评分类别的无转移生存期。采用考克斯回归模型进行多变量检验。预测准确性由Harrell一致性指数和决策曲线分析确定。结果：中位随访时间为84个月。0 - 1分和2 - 8分或更高评分的10年无转移生存概率分别为95%、83%、78%、81%、69%、51%、15%和13%。一致性指数为0.792，而我们使用常规病理结果对Leibovich预后评分进行外部验证的一致性指数为0.778（p
Purpose: We assessed whether supplementing the Leibovich prognosis score with vascular invasion would improve prognostic value to predict metastatic disease in patients with nonmetastatic clear cell renal cell carcinoma.Materials and Methods: We retrospectively evaluated the pathology records of 1,754 patients with nonmetastatic clear cell renal cell carcinoma treated with surgery between 1984 and 2006 at a single tertiary academic center. The Leibovich prognosis score was supplemented by additional scoring for vascular invasion. Metastasis-free survival was assessed using the Kaplan-Meier method for each score category. A Cox regression model was used for multivariate testing. Predictive accuracy was determined by the Harrell concordance index and decision curve analysis.Results: Median followup was 84 months. Ten-year metastasis-free survival probability for a score of 0 to 1 and 2 to 8 or greater was 95%, 83%, 78%, 81%, 69%, 51%, 15% and 13%, respectively. The concordance index was 0.792 compared to 0.778 from our external validation of the Leibovich prognosis score using routine pathological findings (p