Mp36-20 Predicting Recurrence After Radical Surgery for High-Risk Renal Cell Carcinoma: Development and Internal Validation of “Towards” Score

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance I (MP36)1 May 2024MP36-20 PREDICTING RECURRENCE AFTER RADICAL SURGERY FOR HIGH-RISK RENAL CELL CARCINOMA: DEVELOPMENT AND INTERNAL VALIDATION OF "TOWARDS" SCORE Yudai Ishiyama, Kenji Omae, Tsunenori Kondo, Kazuhiko Yoshida, Junpei Iizuka, and Toshio Takagi Yudai IshiyamaYudai Ishiyama , Kenji OmaeKenji Omae , Tsunenori KondoTsunenori Kondo , Kazuhiko YoshidaKazuhiko Yoshida , Junpei IizukaJunpei Iizuka , and Toshio TakagiToshio Takagi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008612.93052.9d.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Considering the reported greater benefits of immunotherapy and its unignorable adverse events in adjuvant therapy for high-risk renal cell carcinoma (hrRCC) accurate prediction may optimize drug use. We aimed to develop and internally validate a clinical predictive model. METHODS: A total of 449 patients who underwent radical surgery for pT3-4 and/or N0-2 and M0 at two institutions were retrospectively evaluated. Clinical variables deemed universally available for use were selected through backward stepwise analysis and were fitted by a multivariable Cox proportional hazards regression model. A point-based risk score was derived from regression coefficients. Discrimination, calibration, and decision curve analysis was conducted to evaluate predictive performance. Internal validation with bootstrapping was performed to correct for optimism. RESULTS: The mean and median follow-up period was 55.3 and 27.8 months, respectively. During the follow-up period, the recurrence rate was 48.6% (n=218) at 68.3 months (median). Stepwise variable selection retained age, ECOG-Performance status, presence or absence of symptoms, size of the primary tumor, pathological T stage, pathological N stage, tumor grade, and histology. Subsequently, the TOWARDS score (range, 0–35) was developed from these variables. Internal validation revealed an optimism-corrected C-index of 0.726 and calibration slope of 0.864. The decision curve analysis showed the superiority of this score over UCLA Integrated Staging System and GRade, Age, Nodes, and Tumor score. CONCLUSIONS: Our novel TOWARDS scoring model had a good accuracy to predict disease recurrence after radical surgery in patients with hrRCC and the clinical practicability was superior to the existing models. Download PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e600 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Yudai Ishiyama More articles by this author Kenji Omae More articles by this author Tsunenori Kondo More articles by this author Kazuhiko Yoshida More articles by this author Junpei Iizuka More articles by this author Toshio Takagi More articles by this author Expand All Advertisement PDF downloadLoading ...