(1) Objective: To develop a clinically useful nomogram that may provide a more individualized and accurate estimation of cancer-specific survival (CSS) for patients with clear-cell (CC) metastatic renal cell carcinoma (mRCC) treated with nephrectomy and vascular endothelial growth factor receptor–tyrosine kinase inhibitor (VEGFR-TKI)-based sequential therapy. (2) Methods: A prospectively maintained database of 145 patients with mRCC treated between 2008 and 2018 was analyzed to predict the CSS of patients receiving sunitinib and second- and third-line therapies according to current standards of practice. A nomogram based on four independent clinical predictors (Eastern Cooperative Oncology Group status, International Metastatic RCC Database Consortium score, the Morphology, Attenuation, Size and Structure criteria and Response Evaluation Criteria in Solid Tumors response criteria) was calculated. The corresponding 1- to 10-year CSS probabilities were then determined from the nomogram. (3) Results: The median age was 60 years (95% CI 57.9–61.4). The disease was metastatic at diagnosis in 59 (40.7%), and 86 (59.3%) developed metastasis during follow-up. Patients were followed for a median 48 (IQR 72; 95% CI 56–75.7) months after first-line VEGFR-TKI initiation. The concordance probability estimator value for the nomogram is 0.778 ± 0.02 (mean ± SE). (4) Conclusions: A nomogram to predict CSS in patients with CC mRCC that incorporates patient status, clinical risk classification and response criteria to first-line VEGFR-TKI at 3 months is presented. This new tool may be useful to clinicians assessing the risk and prognosis of patients with mRCC.
(1) 目的：开发具有临床实用性的列线图，为接受肾切除术及基于血管内皮生长因子受体-酪氨酸激酶抑制剂(VEGFR-TKI)序贯治疗的透明细胞型(CC)转移性肾细胞癌(mRCC)患者提供更个体化、更准确的癌症特异性生存期(CSS)预测。(2) 方法：分析2008年至2018年间接受治疗的145例mRCC患者前瞻性数据库，根据当前实践标准预测接受舒尼替尼及二线、三线治疗患者的CSS。基于四个独立临床预测因子（东部肿瘤协作组体能状态评分、国际转移性肾癌数据库联盟评分、肿瘤形态-密度-大小-结构标准及实体瘤疗效评价标准）构建列线图，并据此计算1-10年CSS概率。(3) 结果：患者中位年龄60岁（95% CI 57.9-61.4）。59例（40.7%）确诊时已发生转移，86例（59.3%）在随访期间出现转移。自一线VEGFR-TKI治疗开始后中位随访48个月（四分位距72；95% CI 56-75.7）。列线图的一致性概率估计值为0.778 ± 0.02（均值±标准误）。(4) 结论：本研究提出整合患者状态、临床风险分层及3个月时一线VEGFR-TKI治疗反应标准的CC型mRCC患者CSS预测列线图。该新工具有助于临床医生评估mRCC患者的风险与预后。
肿瘤(癌症)患者之家