Introduction & Objectives: There are two prognostic models developed specifically for non-metastatic papillary RCC (paprcc). The aim of this multi-institutional study is to compare the accuracy of VENUSS and GRANT prognostic models in patients undergoing curative surgery for non-metastatic papRCC. Materials & Methods: A total of 2335 consecutive patients with sporadic, unilateral, non-metastatic and histopathologically confirmed papRCC, undergoing partial or radical nephrectomy between 1990 and 2023 were collected from 12 different European institutions, retrospectively. The comparison of VENUSS and GRANT prognostic models was analysed in 1779 patients with fully available clinical, histopathological and follow-up parameters. Kaplan-Meier Survival analysis was used to compare survivals between risk groups. Discrimination was assessed using the concordance index. Results: The median age was 63 (IQRs:55-70) years and 76.8% of patients were male. Median VENUSS score was 2 (IQR:0-4), and 66.2%, 22.3% and 11.5% of patients were classified into low, intermediate, and high risk in VENUSS classification, respectively. Median GRANT score was 1 (IQRs: 0-2), and 74.7% and 25.3% of patients were classified into favorable and unfavorable risk group in GRANT classification, respectively. The 5-year RFS was 94.7%, 83.4% and 40.1%, CSS was 98.2%, 91.8% and 54.3%, and OS was 93.1%, 85.1% and 47.5% in VENUSS low, intermediate and high risk groups (all p<0.001). The 5-year RFS was 92.7% and 66.2%, CSS was 97.2% and 76.5%, and OS was 91.7% and 69.3% in GRANT favourable and unfavourable risk groups (all p<0.001). The discrimination of RFS was 78.9% and 76.8% for VENUSS Score and VENUSS risk groups while 73.1% and 70.3% for GRANT Score and GRANT risk groups, respectively. Conclusions: Both VENUSS and GRANT prognostic models significantly predicted RFS, CSS and OS in non-metastatic papRCC undergoing curative surgery. However, discrimination of VENUSS score and risk groups is better than GRANT score and risk groups.
The comparison of prognostic models accuracy in non-metastatic papillary renal cell carcinoma undergoing curative surgical treatments: An analysis from international multi-institutional papillary renal cell carcinoma database
Bertolo, R.;
2024-01-01
Abstract
Introduction & Objectives: There are two prognostic models developed specifically for non-metastatic papillary RCC (paprcc). The aim of this multi-institutional study is to compare the accuracy of VENUSS and GRANT prognostic models in patients undergoing curative surgery for non-metastatic papRCC. Materials & Methods: A total of 2335 consecutive patients with sporadic, unilateral, non-metastatic and histopathologically confirmed papRCC, undergoing partial or radical nephrectomy between 1990 and 2023 were collected from 12 different European institutions, retrospectively. The comparison of VENUSS and GRANT prognostic models was analysed in 1779 patients with fully available clinical, histopathological and follow-up parameters. Kaplan-Meier Survival analysis was used to compare survivals between risk groups. Discrimination was assessed using the concordance index. Results: The median age was 63 (IQRs:55-70) years and 76.8% of patients were male. Median VENUSS score was 2 (IQR:0-4), and 66.2%, 22.3% and 11.5% of patients were classified into low, intermediate, and high risk in VENUSS classification, respectively. Median GRANT score was 1 (IQRs: 0-2), and 74.7% and 25.3% of patients were classified into favorable and unfavorable risk group in GRANT classification, respectively. The 5-year RFS was 94.7%, 83.4% and 40.1%, CSS was 98.2%, 91.8% and 54.3%, and OS was 93.1%, 85.1% and 47.5% in VENUSS low, intermediate and high risk groups (all p<0.001). The 5-year RFS was 92.7% and 66.2%, CSS was 97.2% and 76.5%, and OS was 91.7% and 69.3% in GRANT favourable and unfavourable risk groups (all p<0.001). The discrimination of RFS was 78.9% and 76.8% for VENUSS Score and VENUSS risk groups while 73.1% and 70.3% for GRANT Score and GRANT risk groups, respectively. Conclusions: Both VENUSS and GRANT prognostic models significantly predicted RFS, CSS and OS in non-metastatic papRCC undergoing curative surgery. However, discrimination of VENUSS score and risk groups is better than GRANT score and risk groups.
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