Critical Appraisal of Leibovich 2018 and GRANT Models for Prediction of Cancer-Specific Survival in Non-Metastatic Chromophobe Renal Cell Carcinoma
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Critical Appraisal of Leibovich 2018 and GRANT Models for Prediction of Cancer-Specific Survival in Non-Metastatic Chromophobe Renal Cell Carcinoma. / Piccinelli, Mattia Luca; Morra, Simone; Tappero, Stefano; Cano Garcia, Cristina; Barletta, Francesco; Incesu, Reha-Baris; Scheipner, Lukas; Baudo, Andrea; Tian, Zhe; Luzzago, Stefano; Mistretta, Francesco Alessandro; Ferro, Matteo; Saad, Fred; Shariat, Shahrokh F; Carmignani, Luca; Ahyai, Sascha; Tilki, Derya; Briganti, Alberto; Chun, Felix K H; Terrone, Carlo; Longo, Nicola; de Cobelli, Ottavio; Musi, Gennaro; Karakiewicz, Pierre I.
in: CANCERS, Jahrgang 15, Nr. 7, 2155, 05.04.2023.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Critical Appraisal of Leibovich 2018 and GRANT Models for Prediction of Cancer-Specific Survival in Non-Metastatic Chromophobe Renal Cell Carcinoma
AU - Piccinelli, Mattia Luca
AU - Morra, Simone
AU - Tappero, Stefano
AU - Cano Garcia, Cristina
AU - Barletta, Francesco
AU - Incesu, Reha-Baris
AU - Scheipner, Lukas
AU - Baudo, Andrea
AU - Tian, Zhe
AU - Luzzago, Stefano
AU - Mistretta, Francesco Alessandro
AU - Ferro, Matteo
AU - Saad, Fred
AU - Shariat, Shahrokh F
AU - Carmignani, Luca
AU - Ahyai, Sascha
AU - Tilki, Derya
AU - Briganti, Alberto
AU - Chun, Felix K H
AU - Terrone, Carlo
AU - Longo, Nicola
AU - de Cobelli, Ottavio
AU - Musi, Gennaro
AU - Karakiewicz, Pierre I
PY - 2023/4/5
Y1 - 2023/4/5
N2 - Within the Surveillance, Epidemiology, and End Results database (2000-2019), we identified 5522 unilateral surgically treated non-metastatic chromophobe kidney cancer (chRCC) patients. This population was randomly divided into development vs. external validation cohorts. In the development cohort, the original Leibovich 2018 and GRANT categories were applied to predict 5- and 10-year cancer-specific survival (CSS). Subsequently, a novel multivariable nomogram was developed. Accuracy, calibration and decision curve analyses (DCA) tested the Cox regression-based nomogram as well as the Leibovich 2018 and GRANT risk categories in the external validation cohort. The accuracy of the Leibovich 2018 and GRANT models was 0.65 and 0.64 at ten years, respectively. The novel prognostic nomogram had an accuracy of 0.78 at ten years. All models exhibited good calibration. In DCA, Leibovich 2018 outperformed the novel nomogram within selected ranges of threshold probabilities at ten years. Conversely, the novel nomogram outperformed Leibovich 2018 for other values of threshold probabilities. In summary, Leibovich 2018 and GRANT risk categories exhibited borderline low accuracy in predicting CSS in North American non-metastatic chRCC patients. Conversely, the novel nomogram exhibited higher accuracy. However, in DCA, all examined models exhibited limitations within specific threshold probability intervals. In consequence, all three examined models provide individual predictions that might be suboptimal and be affected by limitations determined by the natural history of chRCC, where few deaths occur within ten years from surgery. Further investigations regarding established and novel predictors of CSS and relying on large sample sizes with longer follow-up are needed to better stratify CSS in chRCC.
AB - Within the Surveillance, Epidemiology, and End Results database (2000-2019), we identified 5522 unilateral surgically treated non-metastatic chromophobe kidney cancer (chRCC) patients. This population was randomly divided into development vs. external validation cohorts. In the development cohort, the original Leibovich 2018 and GRANT categories were applied to predict 5- and 10-year cancer-specific survival (CSS). Subsequently, a novel multivariable nomogram was developed. Accuracy, calibration and decision curve analyses (DCA) tested the Cox regression-based nomogram as well as the Leibovich 2018 and GRANT risk categories in the external validation cohort. The accuracy of the Leibovich 2018 and GRANT models was 0.65 and 0.64 at ten years, respectively. The novel prognostic nomogram had an accuracy of 0.78 at ten years. All models exhibited good calibration. In DCA, Leibovich 2018 outperformed the novel nomogram within selected ranges of threshold probabilities at ten years. Conversely, the novel nomogram outperformed Leibovich 2018 for other values of threshold probabilities. In summary, Leibovich 2018 and GRANT risk categories exhibited borderline low accuracy in predicting CSS in North American non-metastatic chRCC patients. Conversely, the novel nomogram exhibited higher accuracy. However, in DCA, all examined models exhibited limitations within specific threshold probability intervals. In consequence, all three examined models provide individual predictions that might be suboptimal and be affected by limitations determined by the natural history of chRCC, where few deaths occur within ten years from surgery. Further investigations regarding established and novel predictors of CSS and relying on large sample sizes with longer follow-up are needed to better stratify CSS in chRCC.
U2 - 10.3390/cancers15072155
DO - 10.3390/cancers15072155
M3 - SCORING: Journal article
C2 - 37046815
VL - 15
JO - CANCERS
JF - CANCERS
SN - 2072-6694
IS - 7
M1 - 2155
ER -