Sorbellini et al developed a nomogram for predicting recurrence after resection of a conventional clear cell renal cell carcinoma. The authors are from Memorial Sloan-Kettering Cancer Center and Columbia University in New York City.
Patient selection: clear cell renal cell carcinoma, >= 2 cm in diameter, not pathologic stage T4
Parameters:
(1) diameter of the tumor in cm
(2) pathologic T stage using the 2002 criteria
(3) Fuhrman histologic grade
(4) tumor necrosis
(5) vascular invasion
(6) presentation
|
Tumor Diameter in cm |
Points |
|
2 to 8 |
(-0.8688 * ((diameter)^2)) + (16.26 * (diameter)) - 5.725 |
|
8 to 22 |
(2.231 * (diameter)) + 51.16 |
|
Parameter |
Finding |
Points |
|
pathologic T stage |
T1a |
0 |
|
|
T1b |
25.5 |
|
|
T2 |
40.5 |
|
|
T3a |
19.9 |
|
|
T3b |
40.5 |
|
histologic grade |
1 |
1 |
|
|
2 |
0 |
|
|
3 |
27 |
|
|
4 |
60.5 |
|
tumor necrosis |
no |
15.2 |
|
|
yes |
0 |
|
vascular invasion |
no |
0 |
|
|
yes |
35.3 |
|
presentation |
incidental |
0 |
|
|
local |
3.3 |
|
|
systemic |
30.6 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 260
• The higher the score the greater the risk of 5 year recurrence.
|
Total Points |
Probability Free of Recurrence at 5 Years |
|
< 25 |
> 99% |
|
25 to 103 |
(-0.000014 * ((points)^3)) + (0.0011 * ((points)^2)) - (0.0597 * (points)) + 100 |
|
103 to 175.6 |
(-0.006234 * ((points)^2)) + (1.048 * (points)) + 48.13 |
|
175.6 to 230 |
(0.009884 * ((points)^2)) - (4.737 * (points)) + 567.5 |
|
>= 230 |
< 1% |
probability of tumor recurrence at 5 years =
= 100% - (probability of being recurrence free)
Specialty: Hematology Oncology, Surgery, general, Nephrology
ICD-10: ,
