Leibovich et al developed 2 models for predicting survival in patients with metastatic renal cell carcinoma treated by nephrectomy and interleukin-2 immunotherapy. The second and simpler score was referred to as the SANI score (Survival After Nephrectomy and Immunotherapy). The authors are from the University of California in Los Angeles.
Parameters:
(1) N classification (lymph node status)
(2) constitutional symptoms (rash, sweats, weight loss, fatigue, early satiety, decreased appetite, gastrointestinal disturbances, musculoskeletal pain, respiratory symptoms)
(3) location of metastases
(4) histologic appearance of the renal cell carcinoma
(5) TSH levels
Model 1
|
Parameter |
Finding |
Points |
|
lymph node status by N classification |
N0 |
0 |
|
|
N1 |
1 |
|
|
N2 |
2 |
|
constitutional symptoms |
none |
0 |
|
|
yes |
2 |
|
metastases |
bone only |
0 |
|
|
lung only |
0 |
|
|
other (other sites, multiple sites) |
2 |
|
histology |
no sarcomatoid features |
0 |
|
|
sarcomatoid features present |
2 |
|
TSH levels |
< 2.1 mIU/L |
0 |
|
|
2.1 - 4.8 mIU/L |
1 |
|
|
> 4.8 mIU/L |
2 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the worse the prognosis.
|
Score |
Risk Group |
2 Year Survival |
5 Year Survival |
|
0 |
low |
75% |
50% |
|
1 to 5 |
intermediate |
40% |
20% |
|
6 to 10 |
high |
11% |
0% |
Model 2
|
Parameter |
Finding |
Points |
|
lymph node status |
negative for metastases |
0 |
|
|
positive for metastases |
1 |
|
constitutional symptoms |
absent |
0 |
|
|
present |
1 |
|
metastases |
bone only |
0 |
|
|
lung only |
0 |
|
|
other (other sites, multiple sites) |
1 |
|
histology |
no sarcomatoid features |
0 |
|
|
sarcomatoid features present |
1 |
|
TSH levels |
<= 2.0 mIU/L |
0 |
|
|
> 2.0 mIU/L |
1 |
where:
• The original table has 0 points for constitutional symptoms and 1 point for none. This seems to me to be a typographical error.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the worse the prognosis.
|
Score |
Risk Group |
2 Year Survival |
5 Year Survival |
|
0 |
low |
78% |
50% |
|
1 to 3 |
intermediate |
42% |
20% |
|
4 or 5 |
high |
0% |
0% |
Specialty: Hematology Oncology, Surgery, general, Nephrology
ICD-10: ,
