Evidence map›Paper›PMID 30069581›Full record

ArticleWorld journal of urology2018

External validation of a predictive model of survival after cytoreductive nephrectomy for metastatic renal cell carcinoma.

Lorenzo Marconi, Roderick de Bruijn, Erik van Werkhoven, Christian Beisland, Kate Fife, Axel Heidenreich, Anil Kapoor, Jose Karam, Caroline Kauffmann, Tobias Klatte and 11 more

Open access · greenAbstract readValidation Study
PubMed Publisher
In one paragraph

Article in World journal of urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 16 institutions in 9 countries.

Lorenzo MarconiDepartment of Urology, Coimbra University Hospital, Coimbra, Portugal.
Roderick de BruijnDivision of Surgical Oncology, Department of Urology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
Erik van WerkhovenDivision of Surgical Oncology, Department of Urology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
Christian BeislandDepartment of Urology, Haukeland University Hospital, Bergen, Norway.
Kate FifeAddenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, UK.
Axel HeidenreichDepartment of Urology, University Hospital Cologne, Cologne, Germany.
Anil KapoorDepartment of Surgery, McMaster University, Hamilton, Canada.
Jose KaramThe University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Caroline KauffmannDepartment of Urology, University Hospital Cologne, Cologne, Germany.
Tobias KlatteDepartment of Urology, Medical University of Vienna, Vienna, Austria.
Boerje LjungbergDepartment of Urology, Umeå University, Umea, Sweden.
Surena MatinThe University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Daniel SjobergDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Michael StaehlerUniversity Hospital Munich-Grosshadern, Ludwig Maximilian University, Munich, Germany.
Grant D StewartAddenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, UK.
Simon TanguayDepartment of Urology, McGill University, Montreal, Canada.
Robert UzzoFox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA.
Sarah WelshAddenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, UK.
Lori WoodQueen Elizabeth II Health Science Centre, Halifax, Canada.
Chris WoodThe University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Axel BexDivision of Surgical Oncology, Department of Urology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. a.bex@nki.nl.
The University of Texas MD Anderson Cancer Center · USAddenbrooke's Hospital · GBThe Netherlands Cancer Institute · NLUniversity Hospital Cologne · DEAlberta Kidney Disease Network · CAFox Chase Cancer Center · USHaukeland University Hospital · NOLudwig-Maximilians-Universität München · DEMcGill University · CAMcMaster University · CAMedical University of Vienna · ATMemorial Sloan Kettering Cancer Center · USOncode Institute · NLUmeå University · SEUniversity of Coimbra · PTUniversity of Edinburgh · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRecent trials have emphasized the importance of a precise patient selection for cytoreductive nephrectomy (CN). In 2013, a nomogram was developed for pre- and postoperative prediction of the probability of death (PoD) after CN in patients with metastatic renal cell carcinoma. To date, the single-institutional nomogram which included mostly patients from the cytokine era has not been externally validated. Our objective is to validate the predictive model in contemporary patients in the targeted therapy era.

methodsMulti-institutional European and North American data from patients who underwent CN between 2006 and 2013 were used for external validation. Variables evaluated included preoperative serum albumin and lactate dehydrogenase levels, intraoperative blood transfusions (yes/no) and postoperative pathologic stage (primary tumour and nodes). In addition, patient characteristics and MSKCC risk factors were collected. Using the original calibration indices and quantiles of the distribution of predictions, Kaplan-Meier estimates and calibration plots of observed versus predicted PoD were calculated. For the preoperative model a decision curve analysis (DCA) was performed.

resultsOf 1108 patients [median OS of 27 months (95% CI 24.6-29.4)], 536 and 469 patients had full data for the validation of the pre- and postoperative models, respectively. The AUC for the pre- and postoperative model was 0.68 (95% CI 0.62-0.74) and 0.73 (95% CI 0.68-0.78), respectively. In the DCA the preoperative model performs well within threshold survival probabilities of 20-50%. Most important limitation was the retrospective collection of this external validation dataset.

conclusionsIn this external validation, the pre- and postoperative nomograms predicting PoD following CN were well calibrated. Although performance of the preoperative nomogram was lower than in the internal validation, it retains the ability to predict early death after CN.

Indexed as

Cytoreduction Surgical ProceduresNephrectomySurvival RateAdrenal Gland NeoplasmsAgedAntineoplastic AgentsArea Under CurveBlood TransfusionBone NeoplasmsBrain NeoplasmsCarcinoma, Renal CellFemaleHumansIntraoperative CareKaplan-Meier EstimateKidney NeoplasmsAntineoplastic AgentsL-Lactate DehydrogenaseSerum AlbuminCytoreductive nephrectomyMetastatic renal cancerNomogramSelectionTargeted therapyValidation

Identifiers

PMID30069581
OpenAlexW2885135931

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.