Estimating Prognosis of Patients with Kidney Cancer

Abstract

Kidney Cancer has numerous subtypes with Clear Cell Renal Cell Carcinoma (ccRCC) being the most common. Pre-existing prognostic models have not been validated in Canadian patients for recurrence free survival (RFS) and other outcomes. We conducted four studies: 1) externally validated pre-existing RCC prognostic models; 2) assessed the impact of baseline hazard function miscalibration on model assessment; 3) created new models and risk groups for RFS in non-metastatic ccRCC patients; 4) compared new risk groups to existing Canadian guidelines and created new imaging schedules. Pre-existing model performance varied considerably with some models performing well. The effect of baseline hazard function miscalibration varied across distribution shapes but the calibration slope was useful in relatively ranking prognostic model performance. The CKCis prognostic model and risk groups performed better than the existing CUA risk groups. Based on CKCis risk groups fewer scans are recommended in low-risk patients and more scans are recommended in higher risk patients. External validation of the CKCis model is required to assess clinical utility in different populations.