Klatte et al identified prognostic factors for a patient with a clear cell renal cell carcinoma, including cytogenetic factors. This was used to develop a nomogram. The authors are from the University of California at Los Angeles.
Parameters:
(1) T stage
(2) N stage
(3) M stage
(4) Fuhrman grade
(5) loss of 9p
|
Parameter |
Finding |
Points |
|
T stage |
T1 |
0 |
|
|
T2 |
18.8 |
|
|
T3 |
37.6 |
|
|
T4 |
56.4 |
|
N stage |
N0 |
0 |
|
|
N1 or N2 |
31 |
|
M stage |
M0 |
0 |
|
|
M1 |
100 |
|
Fuhrman grade |
Grade 1 |
0 |
|
|
Grade 2 |
33 |
|
|
Grade 3 |
66 |
|
|
Grade 4 |
99 |
|
9p |
present |
0 |
|
|
absent (loss of 9p) |
34 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: around 330
• The higher the score the worse the prognosis.
|
Total Score |
Percent 3 Year Disease Specific Survival |
|
108.5 |
90% |
|
143.4 |
80% |
|
167 |
70% |
|
181.7 |
60% |
|
196.5 |
50% |
|
210 |
40% |
|
222.3 |
30% |
|
236.2 |
20% |
|
252 |
10% |
This can be represented as:
|
Total Score |
Percent 3-Year Disease Specific Survival |
|
< 108 |
> 90% |
|
108 to 252 |
(-0.002158 * ((score)^2)) + (0.1953 * (score)) + 95.38 |
|
> 252 |
< 10% |
Other cytogenetic findings associated with a better prognosis (not significant in multivariate analysis):
(1) deletion of 3p
(2) loss of Y chromosome (in metastatic disease)
Other cytogenetic findings associated with a worse prognosis (not significant in multivariate analysis):
(1) loss of 4p
(2) loss of 14q
Purpose: To evaluate a patient with a clear cell renal cell carcinoma using the prognostic factors of Klatte et al.
Specialty: Hematology Oncology, Surgery, general, Nephrology
Objective: risk factors
ICD-10: C64,
