Mp44-09 Prognostic Nomograms Incorporating Preoperative CRP Level for Predicting Survival Outcomes in Patients With Nonmetastatic Clear Cell Renal Cell Carcinoma: Inmarc Study

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III (MP44)1 May 2024MP44-09 PROGNOSTIC NOMOGRAMS INCORPORATING PREOPERATIVE CRP LEVEL FOR PREDICTING SURVIVAL OUTCOMES IN PATIENTS WITH NONMETASTATIC CLEAR CELL RENAL CELL CARCINOMA: INMARC STUDY Wei Chen, Hajime Tanaka, Masaki Kobayashi, Shohei Fukuda, Akinori Nakayama, Margaret F. Meagher, Rachel Greenwald, Benjamin Schmeusser, Edouard Nicase, Yuma Waseda, Soichiro Yoshida, Ithaar H. Derweesh, Viraj A. Master, Yasuhisa Fujii, and Kazutaka Saito Wei ChenWei Chen , Hajime TanakaHajime Tanaka , Masaki KobayashiMasaki Kobayashi , Shohei FukudaShohei Fukuda , Akinori NakayamaAkinori Nakayama , Margaret F. MeagherMargaret F. Meagher , Rachel GreenwaldRachel Greenwald , Benjamin SchmeusserBenjamin Schmeusser , Edouard NicaseEdouard Nicase , Yuma WasedaYuma Waseda , Soichiro YoshidaSoichiro Yoshida , Ithaar H. DerweeshIthaar H. Derweesh , Viraj A. MasterViraj A. Master , Yasuhisa FujiiYasuhisa Fujii , and Kazutaka SaitoKazutaka Saito View All Author Informationhttps://doi.org/10.1097/01.JU.0001009508.69111.d0.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Preoperative C-reactive protein (CRP) is a valuable prognostic biomarker for clear cell renal cell carcinoma (ccRCC). However, relying exclusively on a single factor for prognostic evaluation could introduce potential biases, as multiple factors contribute to cancer prognosis. We aimed to develop and validate prognostic nomograms and an integrated tool (SPPRC) incorporating preoperative CRP levels for predicting survival outcomes in patients with nonmetastatic ccRCC (nmccRCC). METHODS: The INMARC database was retrospectively analyzed for nmccRCC patients who underwent partial/radical nephrectomy without any perioperative treatment (ethical approval number M2021-071). A total of 2284 patients were enrolled and randomly allocated to the training (n=1599, 70%) and validation (n=685, 30%) cohorts. Nomograms and a user-friendly integrated tool for predicting OS, CSS, and RFS were developed. The accuracies of the models were assessed using C-index and calibration. RESULTS: Following a median follow-up of 5.9 years, 318 (13.92%) cases died of any cause, 109 (4.77%) died of renal cancer, and 282 (12.35%) developed recurrence. The median preoperative CRP level was 1.82 (IQR: 0.63-5.40) mg/L. On the multivariable analyses using the training cohort, high CRP level was independently associated with worse OS, CSS, and RFS. Predictors including the preoperative CRP, surgical approach, necrosis, Fuhrman grade, and pathological T stage for OS; preoperative CRP, necrosis, and pathological T stage for CSS; and preoperative CRP, sex, Fuhrman grade, and pathological T stage for RFS, leading to the development of individualized nomograms. In the validation cohort, the nomograms showed good discrimination, as indicated by the C-index of 0.77 (95%CI, 0.72-0.82) for OS, 0.87 (95%CI, 0.82-0.93) for CSS, and 0.77 (95%CI, 0.71-0.82) for RFS. Acceptable calibration was identified by the calibration curves for all the endpoint at 12, 36, and 60 months. The user-friendly integrated tool was further developed based on the nomograms. CONCLUSIONS: We presented nomograms and integrated tool incorporating preoperative CRP to predict the prognosis of nmccRCC, which may help personalized risk stratification and treatment planning for these patients. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e733 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Wei Chen More articles by this author Hajime Tanaka More articles by this author Masaki Kobayashi More articles by this author Shohei Fukuda More articles by this author Akinori Nakayama More articles by this author Margaret F. Meagher More articles by this author Rachel Greenwald More articles by this author Benjamin Schmeusser More articles by this author Edouard Nicase More articles by this author Yuma Waseda More articles by this author Soichiro Yoshida More articles by this author Ithaar H. Derweesh More articles by this author Viraj A. Master More articles by this author Yasuhisa Fujii More articles by this author Kazutaka Saito More articles by this author Expand All Advertisement PDF downloadLoading ...