MedComm (Aug 2023)
Development and validation of a prognostic model incorporating tumor thrombus grading for nonmetastatic clear cell renal cell carcinoma with tumor thrombus: A multicohort study
- Le Qu,
- Hui Chen,
- Qi Chen,
- Silun Ge,
- Aimin Jiang,
- Nengwang Yu,
- Yulin Zhou,
- Michał Kunc,
- Ye Zhou,
- Xiang Feng,
- Wei Zhai,
- Zhenjie Wu,
- Miaoxia He,
- Yaoming Li,
- Rui Chen,
- Bo Han,
- Xing Zeng,
- Yao Fu,
- Changwei Ji,
- Xiang Fan,
- Guangyuan Zhang,
- Cheng Zhao,
- Taile Jing,
- Chenchen Feng,
- Hongwei Zhao,
- Di Sun,
- Liang Wang,
- Sheng Tai,
- Cheng Zhang,
- Shaohao Chen,
- Yixun Liu,
- Haifeng Wang,
- Jinli Gao,
- Yufeng Gu,
- He Miao,
- Tangliang Zhao,
- Xiaoming Yi,
- Chaopeng Tang,
- Dian Fu,
- Haowei He,
- Qiu Rao,
- Wenquan Zhou,
- Ning Xu,
- Gongxian Wang,
- Chaozhao Liang,
- Zhiyu Liu,
- Dan Xia,
- Xiongbing Zu,
- Ming Chen,
- Hongqian Guo,
- Weijun Qin,
- Zhe Wang,
- Wei Xue,
- Benkang Shi,
- Shaogang Wang,
- Junhua Zheng,
- Cheng Chen,
- Łukasz Zapała,
- Jingping Ge,
- Linhui Wang
Affiliations
- Le Qu
- Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Hui Chen
- Department of Pathology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Qi Chen
- Department of Health Statistics Naval Medical University Shanghai China
- Silun Ge
- Department of Urology Jinling Hospital Jinling School of Clinical Medicine Nanjing Medical University Nanjing Jiangsu China
- Aimin Jiang
- Department of Urology Changhai Hospital Naval Medical University Shanghai China
- Nengwang Yu
- Department of Urology Qilu Hospital of Shandong University Jinan Shandong China
- Yulin Zhou
- Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Michał Kunc
- Department of Pathomorphology Medical University of Gdańsk Gdańsk Poland
- Ye Zhou
- Department of Urology Changhai Hospital Naval Medical University Shanghai China
- Xiang Feng
- Department of Urology Changhai Hospital Naval Medical University Shanghai China
- Wei Zhai
- Department of Urology Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai Shanghai China
- Zhenjie Wu
- Department of Urology Changhai Hospital Naval Medical University Shanghai China
- Miaoxia He
- Department of Pathology Changhai Hospital Naval Medical University Shanghai China
- Yaoming Li
- Department of Urology Daping Hospital Army Medical University Chongqing China
- Rui Chen
- Department of Urology Changhai Hospital Naval Medical University Shanghai China
- Bo Han
- Department of Pathology Qilu Hospital of Shandong University Jinan Shandong China
- Xing Zeng
- Department of Urology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China
- Yao Fu
- Department of Pathology Drum Tower Hospital Clinical School of Medical College Nanjing University Nanjing Jiangsu China
- Changwei Ji
- Department of Urology Drum Tower Hospital Clinical School of Medical College Nanjing University Nanjing Jiangsu China
- Xiang Fan
- Department of Pathology Zhongda Hospital Southeast University Nanjing Jiangsu China
- Guangyuan Zhang
- Department of Urology Zhongda Hospital Southeast University Nanjing Jiangsu China
- Cheng Zhao
- Department of Urology Xiangya Hospital Central South University Changsha Hunan China
- Taile Jing
- Department of Urology The First Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang China
- Chenchen Feng
- Department of Urology Huashan Hospital Fudan University Shanghai China
- Hongwei Zhao
- Department of Urology Affiliated Yantai Yuhuangding Hospital Qingdao University Yantai Shandong China
- Di Sun
- Department of Pathology Affiliated Yantai Yuhuangding Hospital Qingdao University Yantai Shandong China
- Liang Wang
- Department of Urology The Second Affiliated Hospital of Dalian Medical University Dalian Liaoning China
- Sheng Tai
- Department of Urology The First Affiliated Hospital of Anhui Medical University Hefei Anhui China
- Cheng Zhang
- Department of Urology The First Affiliated Hospital of Nanchang University Nanchang Jiangxi China
- Shaohao Chen
- Department of Urology Urology Research Institute The First Affiliated Hospital Fujian Medical University Fuzhou Fujian China
- Yixun Liu
- Department of Urology Anhui Provincial Hospital The First Hospital of the University of Science and Technology of China Hefei Anhui China
- Haifeng Wang
- Department of Urology Shanghai East Hospital Tongji University Shanghai China
- Jinli Gao
- Department of Pathology Shanghai East Hospital Tongji University Shanghai China
- Yufeng Gu
- Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- He Miao
- Department of Urology Jinling Hospital Jinling School of Clinical Medicine Nanjing Medical University Nanjing Jiangsu China
- Tangliang Zhao
- Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Xiaoming Yi
- Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Chaopeng Tang
- Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Dian Fu
- Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Haowei He
- Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Qiu Rao
- Department of Pathology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Wenquan Zhou
- Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Ning Xu
- Department of Urology Urology Research Institute The First Affiliated Hospital Fujian Medical University Fuzhou Fujian China
- Gongxian Wang
- Department of Urology The First Affiliated Hospital of Nanchang University Nanchang Jiangxi China
- Chaozhao Liang
- Department of Urology The First Affiliated Hospital of Anhui Medical University Hefei Anhui China
- Zhiyu Liu
- Department of Urology The Second Affiliated Hospital of Dalian Medical University Dalian Liaoning China
- Dan Xia
- Department of Urology The First Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang China
- Xiongbing Zu
- Department of Urology Xiangya Hospital Central South University Changsha Hunan China
- Ming Chen
- Department of Urology Zhongda Hospital Southeast University Nanjing Jiangsu China
- Hongqian Guo
- Department of Urology Drum Tower Hospital Clinical School of Medical College Nanjing University Nanjing Jiangsu China
- Weijun Qin
- Department of Urology Xijing Hospital Fourth Military Medical University Xi'an Shanxi China
- Zhe Wang
- Department of Pathology Xijing Hospital Fourth Military Medical University Xi'an Shanxi China
- Wei Xue
- Department of Urology Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai Shanghai China
- Benkang Shi
- Department of Urology Qilu Hospital of Shandong University Jinan Shandong China
- Shaogang Wang
- Department of Urology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China
- Junhua Zheng
- Department of Urology Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai Shanghai China
- Cheng Chen
- Department of Medical Oncology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Łukasz Zapała
- Clinic of General Oncological and Functional Urology Medical University of Warsaw Warsaw Poland
- Jingping Ge
- Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing Jiangsu China
- Linhui Wang
- Department of Urology Changhai Hospital Naval Medical University Shanghai China
- DOI
- https://doi.org/10.1002/mco2.300
- Journal volume & issue
-
Vol. 4,
no. 4
pp. n/a – n/a
Abstract
Abstract There is significant variability with respect to the prognosis of nonmetastatic clear cell renal cell carcinoma (ccRCC) patients with venous tumor thrombus (VTT). By applying multiregion whole‐exome sequencing on normal‐tumor‐thrombus‐metastasis quadruples from 33 ccRCC patients, we showed that metastases were mainly seeded by VTT (81.8%) rather than primary tumors (PTs). A total of 706 nonmetastatic ccRCC patients with VTT from three independent cohorts were included in this study. C‐index analysis revealed that pathological grading of VTT outperformed other indicators in risk assessment (OS: 0.663 versus 0.501–0.610, 0.667 versus 0.544–0.651, and 0.719 versus 0.511–0.700 for Training, China‐Validation, and Poland‐Validation cohorts, respectively). We constructed a risk predicting model, TT‐GPS score, based on four independent variables: VTT height, VTT grading, perinephric fat invasion, and sarcomatoid differentiation in PT. The TT‐GPS score displayed better discriminatory ability (OS, c‐index: 0.706–0.840, AUC: 0.788–0.874; DFS, c‐index: 0.691–0.717, AUC: 0.771–0.789) than previously reported models in risk assessment. In conclusion, we identified for the first‐time pathological grading of VTT as an unheeded prognostic factor. By incorporating VTT grading, the TT‐GPS score is a promising prognostic tool in predicting the survival of nonmetastatic ccRCC patients with VTT.
Keywords
- clear cell renal cell carcinoma
- pathological grading
- prognostic model
- risk stratification
- venous tumor thrombus
