ArticleBMC urology2025
Tumor necrosis-informed prognostic nomogram for clear cell renal cell carcinoma model development and clinical validation.
Article in BMC urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Prognostic significance of systemic immunoinflammatory biomarkers and pathological features in clear cell renal cell carcinoma: a multicenter study.Annals of medicine · 2026Trial
- A new cuproptosis-associated lncRNA signature predicts the prognosis of clear cell renal cell carcinoma patients.Discover oncology · 2026Article
- Identification the Tumor Mechanics-Related Biomarkers in Gastric Cancer Patients Based on Bioinformatics and Machine Learning.International journal of general medicine · 2025Article
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Authors and funding
14 authors.
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Abstract
backgroundThis study investigated the prognostic role of tumor necrosis (TN) in non-metastatic clear cell renal cell carcinoma (ccRCC).
methodsWe enrolled 1,212 non-metastatic ccRCC patients undergoing nephrectomy (2013-2023) in this retrospective study. Computer-generated randomization allocated cases to derivation (70%, n = 848) and validation cohorts (30%, n = 364). Kaplan-Meier methodology compared overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) across TN-positive and TN-negative cohorts, with intergroup differences evaluated by log-rank testing. Prognostic determinants were identified through univariate and multivariate Cox proportional hazards regression. We developed a prognostic nomogram through stepwise Cox regression that integrated TN status with key clinicopathological variables. Validation employed: Harrell's C-index, time-dependent ROC curves, calibration plots, and decision curve analysis (DCA).
resultsTN positivity was significantly associated with reduced OS (HR: 2.12, 95% CI: 1.65-2.73; P < 0.001), CSS (HR: 2.45, 95% CI: 1.82-3.29; P < 0.001), and RFS (HR: 1.89, 95% CI: 1.32-2.70; P = 0.003) in multivariate analysis. The prognostic nomogram demonstrated excellent discrimination in the validation cohort, with C-indices of 0.855 (OS), 0.870 (CSS), and 0.724 (RFS). Time-dependent ROC analysis revealed robust predictive accuracy for OS at 1- (AUC: 0.892), 3- (AUC: 0.846), and 5-year (AUC: 0.826) intervals. Calibration curves demonstrated excellent consistency between predicted probabilities and actual outcomes. Decision curve analysis further revealed greater clinical net benefit than pT stage system and WHO/ISUP classification.
conclusionTN is an independent prognostic marker in non-metastatic ccRCC. The novel nomogram integrating TN provides reliable risk stratification, aiding personalized postoperative management.
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