کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3925076 1253122 2009 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
A Preoperative Prognostic Model for Patients Treated with Nephrectomy for Renal Cell Carcinoma
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی زنان، زایمان و بهداشت زنان
پیش نمایش صفحه اول مقاله
A Preoperative Prognostic Model for Patients Treated with Nephrectomy for Renal Cell Carcinoma
چکیده انگلیسی

BackgroundCurrently two pretreatment prognostic models with limited accuracy (65–67%) can be used to predict survival in patients with localized renal cell carcinoma (RCC).ObjectiveWe set out to develop a more accurate pretreatment model for predicting RCC-specific mortality after nephrectomy for all stages of RCC.Design, setting, and participantsThe data originated from a series of prospectively recorded contemporary cases of patients treated with radical or partial nephrectomy between 1984 and 2006. Model development was performed using data from 2474 patients from five centers and external validation was performed using data from 1972 patients from seven centers.MeasurementsThe probability of RCC-specific mortality was modeled using Cox regression. The significance of the predictors was confirmed using competing risks analyses, which account for mortality from other causes.Results and limitationsMedian follow-up in patients who did not die of RCC-specific causes was 4.2 yr and 3.5 yr in the development and validation cohorts, respectively. The freedom from cancer-specific mortality rates in the nomogram development cohort were 75.4% at 5 yr after nephrectomy and 68.3% at 10 yr after nephrectomy. All variables except gender achieved independent predictor status. In the external validation cohort the nomogram predictions were 88.1% accurate at 1 yr, 86.8% accurate at 2 yr, 86.8% accurate at 5 yr, and 84.2% accurate at 10 yr.ConclusionsOur model substantially exceeds the accuracy of the existing pretreatment models. Consequently, the proposed nomogram-based predictions may be used as benchmark data for pretreatment decision making in patients with various stages of RCC.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: European Urology - Volume 55, Issue 2, February 2009, Pages 287–295
نویسندگان
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