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Postoperative Prognostic Model of Kattan et al for a Patient with Renal Cell Carcinoma

Purpose: To evaluate a patient with renal cell carcinoma following nephrectomy using the prognostic model of Kattan et al.

Description

Kattan et al developed a predictive model for evaluating a patient with renal cell carcinoma following nephrectomy. This can help identify patients who may require closer monitoring for recurrence and more aggressive therapy. The authors are from Memorial Sloan-Kettering Cancer Center in New York City.


Parameters:

(1) symptoms

(2) histology of the tumor

(3) tumor size in centimeters

(4) pathologic stage from 1997 TNM criteria

 

points for tumor size =

= 5 * (diameter of the tumor in centimeters)

 

Parameter

Finding

Points

symptoms

local

0

 

incidental

0.6

 

systemic

31.5

histologic type

chromophobe

0

 

papillary

9

 

conventional clear cell

39

pathologic stage

pT1

0

 

pT2

19

 

pT3a

7

 

pT3b

31

 

pT3c

31

 

where:

• The scheme described pathologic stages from P1 to P3c. After reviewing the TNM staging criteria the only matching parameter is the pathologic T stage (pT).

 

total number of points =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: > 200

• The higher the score the lower the chances of recurrence free survival.

 

Total Points

Probability of 5 Year (60 Month) Tumor Free Survival

< 9

> 98%

9

98%

34

96%

49

94%

68

90%

84

85%

95

80%

112

70%

125

60%

136

50%

146

40%

156

30%

167

20%

> 167

< 20%

 

percent tumor free survival with 9 to 95 points =

= (-0.002183 * ((points)^2)) + (0.0222 * (points)) + 97.9218

 

percent tumor free survival with 95 to 167 points =

= (-0.003505 * ((points)^2)) + (0.06557 * (points)) + 105.9342


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Specialty

Objective

ICD-10