umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
External validation of a predictive model of survival after cytoreductive nephrectomy for metastatic renal cell carcinoma
Show others and affiliations
2018 (English)In: World journal of urology, ISSN 0724-4983, E-ISSN 1433-8726, Vol. 36, no 12, p. 1973-1980Article in journal (Refereed) Published
Abstract [en]

IntroductionRecent trials have emphasized the importance of a precise patient selection for cytoreductive nephrectomy (CN). In 2013, a nomogram was developed for pre- and postoperative prediction of the probability of death (PoD) after CN in patients with metastatic renal cell carcinoma. To date, the single-institutional nomogram which included mostly patients from the cytokine era has not been externally validated. Our objective is to validate the predictive model in contemporary patients in the targeted therapy era.MethodsMulti-institutional European and North American data from patients who underwent CN between 2006 and 2013 were used for external validation. Variables evaluated included preoperative serum albumin and lactate dehydrogenase levels, intraoperative blood transfusions (yes/no) and postoperative pathologic stage (primary tumour and nodes). In addition, patient characteristics and MSKCC risk factors were collected. Using the original calibration indices and quantiles of the distribution of predictions, Kaplan-Meier estimates and calibration plots of observed versus predicted PoD were calculated. For the preoperative model a decision curve analysis (DCA) was performed.ResultsOf 1108 patients [median OS of 27months (95% CI 24.6-29.4)], 536 and 469 patients had full data for the validation of the pre- and postoperative models, respectively. The AUC for the pre- and postoperative model was 0.68 (95% CI 0.62-0.74) and 0.73 (95% CI 0.68-0.78), respectively. In the DCA the preoperative model performs well within threshold survival probabilities of 20-50%. Most important limitation was the retrospective collection of this external validation dataset.ConclusionsIn this external validation, the pre- and postoperative nomograms predicting PoD following CN were well calibrated. Although performance of the preoperative nomogram was lower than in the internal validation, it retains the ability to predict early death after CN.

Place, publisher, year, edition, pages
Springer, 2018. Vol. 36, no 12, p. 1973-1980
Keywords [en]
Metastatic renal cancer, Cytoreductive nephrectomy, Targeted therapy, Selection, Validation, Nomogram
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-154902DOI: 10.1007/s00345-018-2427-zISI: 000452271200009PubMedID: 30069581OAI: oai:DiVA.org:umu-154902DiVA, id: diva2:1275050
Available from: 2019-01-04 Created: 2019-01-04 Last updated: 2019-01-04Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Authority records BETA

Ljungberg, Börje

Search in DiVA

By author/editor
Ljungberg, BörjeStewart, Grant D.
By organisation
Urology and Andrology
In the same journal
World journal of urology
Urology and Nephrology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 39 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf