A Review of Integrated Staging Systems for Renal Cell Carcinoma

• Published in: European urology Vol. 62; no. 2; pp. 303 - 314
• Main Authors: Meskawi, Malek, Sun, Maxine, Trinh, Quoc-Dien, Bianchi, Marco, Hansen, Jens, Tian, Zhe, Rink, Michael, Ismail, Salima, Shariat, Shahrokh F, Montorsi, Francesco, Perrotte, Paul, Karakiewicz, Pierre I
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier B.V 01.08.2012; Elsevier
• Subjects: Biological and medical sciences; Carcinoma, Renal Cell - mortality; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - surgery; Female; Humans; Integrated staging system; Kidney Neoplasms - mortality; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Kidneys; Male; Medical sciences; Models, Biological; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Nephrectomy - methods; Nephrology. Urinary tract diseases; Nomograms; Prognosis; Prognostic models; Renal cell carcinoma; Treatment Outcome; Tumors of the urinary system; Urology; Renal cell carcinoma; Prognostic models; Integrated staging system; Kidney disease; Nephrology; Urinary system disease; Carcinoma; Prognosis; Malignant tumor; Review; Urology; Kidney cancer; Classification; Grawitz tumor; Integrated system; Models; Bibliographic review; Cancer
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/j.eururo.2012.04.049

Abstract Context Several outstanding integrated staging systems (ISSs) have been devised for patients with renal cell carcinoma (RCC). Objective To review the available literature on existing ISSs. Evidence acquisition A nonsystematic search was conducted using Medline and PubMed databases. Original articles, review articles, and editorials addressing the development and validation of ISSs in RCC published up to February 2012 were identified. The search was limited to the English language. Keywords included kidney cancer, renal cell carcinoma, nomogram, risk group, prognosis, predictive accuracy, external validation , and discrimination. Links to related articles and cross-reading of citations in related articles were surveyed. All articles with a pertinent level of evidence were included and represent the basis for the current review article. Evidence synthesis In nephrectomy patients, a variety of models have been developed for prediction of recurrence and survival, both in the preoperative and postoperative settings. Several of those models relied on variables that are not routinely available in clinical practice. Not all tools were externally validated. In patients treated with systemic therapy, novel tools that were developed and validated in the targeted therapy era replaced tools devised during the cytokine era. Conclusions The development of ISSs for prediction of risk or prognosis in the context of RCC has evolved and improved. In the targeted therapy era, the urologic community should focus on direct comparisons of existing tools with the intent of identifying the optimal ISS for each specific end point.