Predictive factors of upstaging to stage T3a in patients with clinical stage T1 renal cancer
10.3969/j.issn.1009-8291.2023.03.009
- VernacularTitle:临床T1期肾细胞癌术后升级至病理T3a期的风险预测因素
- Author:
Jiawei ZHU
1
,
2
;
Rui CHEN
1
,
2
;
Hailong LI
1
;
Jie ZHOU
1
,
2
;
Rumin WEN
1
Author Information
1. Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002
2. Graduate School, Xuzhou Medical University, Xuzhou 221002, China
- Publication Type:Journal Article
- Keywords:
renal cell carcinoma;
pT3a;
inflammatory markers;
cystatin C;
RENAL score
- From:
Journal of Modern Urology
2023;28(3):216-221
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To investigate the predictive factors of clinical T1 (cT1) stage renal cell carcinoma (RCC) escalation to T3a (pT3a), hoping to identify high-risk patients with occult pT3a features. 【Methods】 A total of 666 patients with cT1 RCC who underwent radical or partial nephrectomy were involved and divided into upstaging group and non-upstaging group. The independent predictive factors of cT1 to pT3a stage were determined with univariate and multivariate logistic regression analyses. A model was established. The area under the receiver operator characteristic (ROC) curve (AUC) and calibration plot were used to assess the predictive model’s discrimination and calibration. 【Results】 The upgrading rate was 11.4% (n=76). The RENAL score, neutrophil-to-lymphocyte ratio (NLR), prognosis nutrition index (PNI) and Cystatin C (Cys C) were correlated to pT3a upgrading. Our model exhibited good discrimination (AUC=0.726, 95%CI:0.662-0.791) and decent calibration. In the internal validation, the high C-index value of 0.717 was still attainable. 【Conclusions】 RENAL score, NLR, PNI, and Cys C can be used to predict the risk of postoperative pT3a stage escalation in patients with cT1 stage renal cancer. Urologists can complete risk stratification and treatment based on these indicators.
