Patients with recurrent or metastatic renal cell carcinoma can be separated into 5 risk groups based on clinical status, with the assigned status correlating with prognosis.
Patients inclusion: recurrent and/or metastatic renal cell carcinoma
Patient Exclusion:
• initial ECOG performance status 4
• major surgery within 3 weeks
• inadequate bone marrow or liver function
• exploratory surgery or biopsy within 2 weeks (reason for exclusion not stated)
• any chemotherapy or radiotherapy within 1 month unless there was disease progression and all treatment related complications were abated
Risk factors:
(1) initial ECOG performance status
(2) time from initial diagnosis
(3) weight loss in previous 6 months
(4) history of previous cytotoxic chemotherapy
|
Risk Factors |
Values |
Points |
|
initial ECOG performance status |
0 |
0 |
|
|
1 |
1 |
|
|
2 |
2 |
|
|
3 |
3 |
|
|
4 |
(excluded) |
|
time from initial diagnosis |
> 1 year |
0 |
|
|
<= 1 year |
1 |
|
number of metastatic sites |
0 or 1 metastatic sites |
0 |
|
|
> 1 metastatic sites |
1 |
|
weight loss in previous 6 months |
absent |
0 |
|
|
present |
1 |
|
prior cytotoxic chemotherapy |
no |
0 |
|
|
yes |
1 |
where:
• 0 metastatic sites indicates locally recurrent disease only
|
Metastatic Site |
Count As |
|
lung parenchyma and/or pleura |
1 |
|
liver |
1 |
|
brain |
1 |
|
all other sites combined |
1 |
sum of risk factors =
= (points for ECOG status) + (points for time from initial diagnosis) + (point for number of metastatic sites) + (point for weight loss) + (point for cytotoxic chemotherapy)
subscore =
= (point for number of metastatic sites) + (point for weight loss) + (point for cytotoxic chemotherapy)
effective number of risk factors =
= (sum of risk factors) - (1 if subscore = 3, else 0)
Interpretation:
• minimum effective number of risk factors 0
• maximum effective number of risk factors 6
|
Effective Number of Risk Factors |
Risk Group |
Survival Rate at 1 Year |
Median Survival in Months |
|
0 or 1 |
1 |
52% |
12.8 |
|
2 |
2 |
31% |
7.7 |
|
3 |
3 |
18% |
5.3 |
|
4 |
4 |
9% |
3.4 |
|
5 or 6 |
5 |
1% |
2.1 |
Specialty: Hematology Oncology, Surgery, general, Nephrology
ICD-10: ,
