Construction and validation of a prognostic model for non-metastatic synchronous sporadic bilateral renal cell carcinoma based on SEER database and domestic cohort
Objective:To investigate the construction of a survival model for non-metastatic synchronous spo-radic bilateral renal cell carcinoma(SSBRCC)and evaluate its clinical application with multicenter cohorts.Meth-ods:We retrospectively analyzed the clinical data of 554 patients with non-metastatic SSBRCC(SEER cohort)en-rolled in the SEER database from 2010 to 2015 and 111 patients with non-metastatic SSBRCC(validation cohort)admitted to Jinling Hospital,Medical School of Nanjing University and Qilu Hospital of Shandong University from April 2007 to November 2021.We compared the difference in postoperative 5-year overall survival(OS)be-tween different surgical treatment techniques for SSBRCC by Kaplan-Meier survival analysis.Independent prog-nostic factors in SSBRCC were screened using univariate and multifactorial Cox regression analysis,and Nomo-gram prognostic models were constructed based on these independent prognostic factors.Results:Partial nephrec-tomy(PN)on both sides in patients with SSBRCC provided better long-term survival benefits than radical ne-phrectomy(RN)on at least one side.Age at initial diagnosis ≥60 years,TNM staging at T3 or T4,sarcomatous features in histological pathology,nuclear classification Ⅲ or Ⅳ,and RN on at least one side were independent risk factors in survival after SSBRCC surgery.The 5-year OS Nomogram prognostic model constructed based on the above independent prognostic factors had good predictive validity(SEER cohort:C-index=0.773,Validation cohort:C-index=0.918).Conclusion:Our multicenter-based survival model can effectively predict 5-year OS in patients with non-metastatic SSBRCC,which is important for assessing clinical treatment prognosis.
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