Mp36-05 Nodesafe Nomogram: A Novel Score System to Predict Lymph Node Involvement at the Time of Nephrectomy or Nodal Recurrence in Non-Metastatic Renal Cell Carcinoma

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance I (MP36)1 May 2024MP36-05 NODESAFE NOMOGRAM: A NOVEL SCORE SYSTEM TO PREDICT LYMPH NODE INVOLVEMENT AT THE TIME OF NEPHRECTOMY OR NODAL RECURRENCE IN NON-METASTATIC RENAL CELL CARCINOMA Cesare Saitta, Jonathan A. Afari, Mimi V. Nguyen, Kevin Hakimi, Dattatraya Patil, Hajime Tanaka, Julian Cortes, Jacob Roberts, Margaret F. Meagher, Franklin Liu, Mirha Mahmood, Joshua Matian, Mariam Mansour, Dhruv Puri, Clara Cerrato, Kit L. Yuen, Masaki Kobayashi, Shohei Fukuda, Wei Chen, Edouard Nicaise, Nahar Imtiaz, Rachel Greenwald, Nicolò M. Buffi, Giovanni Lughezzani, Yasuhisa Fujii, Viraj Master, and Ithaar H. Derweesh Cesare SaittaCesare Saitta , Jonathan A. AfariJonathan A. Afari , Mimi V. NguyenMimi V. Nguyen , Kevin HakimiKevin Hakimi , Dattatraya PatilDattatraya Patil , Hajime TanakaHajime Tanaka , Julian CortesJulian Cortes , Jacob RobertsJacob Roberts , Margaret F. MeagherMargaret F. Meagher , Franklin LiuFranklin Liu , Mirha MahmoodMirha Mahmood , Joshua MatianJoshua Matian , Mariam MansourMariam Mansour , Dhruv PuriDhruv Puri , Clara CerratoClara Cerrato , Kit L. YuenKit L. Yuen , Masaki KobayashiMasaki Kobayashi , Shohei FukudaShohei Fukuda , Wei ChenWei Chen , Edouard NicaiseEdouard Nicaise , Nahar ImtiazNahar Imtiaz , Rachel GreenwaldRachel Greenwald , Nicolò M. BuffiNicolò M. Buffi , Giovanni LughezzaniGiovanni Lughezzani , Yasuhisa FujiiYasuhisa Fujii , Viraj MasterViraj Master , and Ithaar H. DerweeshIthaar H. Derweesh View All Author Informationhttps://doi.org/10.1097/01.JU.0001008612.93052.9d.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We sought to develop a preoperative nomogram called NODESAFE (NODE SAFEty) to predict nodal involvement (NI) at time of surgery or subsequent follow up in localized renal cell carcinoma (RCC), as the role of lymphadenectomy in localized RCC remains controversial. METHODS: We conducted a multicenter retrospective analysis of RCC patients who underwent primary surgical resection. Patients with clinical metastasis at presentation were excluded. NI was defined as presence of histological RCC with lymphadenectomy at time of surgery, or subsequent development histologically proven NI. NODESAFE model was constructed through a stepwise multivariable logistic regression (MLR) model. Accuracy was tested with receiver operator characteristic estimated area under the curve (AUC). Internal validation was performed through cross validation analysis. RESULTS: 2,297 patients met inclusion criteria. On MLR: cN odds ratio (OR) 5.90, p<0.001, tumor size ≥6cm (OR 3.04, p<0.001), c-reactive protein ≥8.5mg/L (OR 1.98, p=0.011), neutrophil-lymphocyte ratio ≥2.5 (OR 1.74, p=0.034) , low enhancement in CT imaging (OR 2.05, p=0.009), hypertension (OR 2.78, p<0.001) and Charlson Comorbidity Index ≥5 (OR 2.57, p=0.001) were independent predictors for NI. NODESAFE model was constructed from these variables (Figure 1). A web risk calculators is available at http://nodesafe.pythonanywhere.com/. AUC was 0.86 and 0.84 after cross validation analysis. 3.9% threshold probabilities displayed 73.5% sensitivity, 84.5% specificity and 98.8% negative predictive value. CONCLUSIONS: Combining clinical features, serum biomarkers and radiographic findings, we developed a model capable of predicting NI with high degree of accuracy. NODESAFE may refine clinical decision making with respect to the performance of lymphadenectomy at the time of surgery, post-surgical surveillance, and spur consideration for adjuvant therapy. Download PPT Source of Funding: Financial support was received from Stephen Weissman Kidney Cancer Research Found © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e593 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Cesare Saitta More articles by this author Jonathan A. Afari More articles by this author Mimi V. Nguyen More articles by this author Kevin Hakimi More articles by this author Dattatraya Patil More articles by this author Hajime Tanaka More articles by this author Julian Cortes More articles by this author Jacob Roberts More articles by this author Margaret F. Meagher More articles by this author Franklin Liu More articles by this author Mirha Mahmood More articles by this author Joshua Matian More articles by this author Mariam Mansour More articles by this author Dhruv Puri More articles by this author Clara Cerrato More articles by this author Kit L. Yuen More articles by this author Masaki Kobayashi More articles by this author Shohei Fukuda More articles by this author Wei Chen More articles by this author Edouard Nicaise More articles by this author Nahar Imtiaz More articles by this author Rachel Greenwald More articles by this author Nicolò M. Buffi More articles by this author Giovanni Lughezzani More articles by this author Yasuhisa Fujii More articles by this author Viraj Master More articles by this author Ithaar H. Derweesh More articles by this author Expand All Advertisement PDF downloadLoading ...