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Patient's self-reported quality of life as a prognostic factor in metastatic renal cell carcinoma initially treated with TKI: nomogram proposal

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A Letter to the Editor to this article was published on 20 May 2024

Abstract

Background

Numerous prognostic factors have been described for metastatic renal cell carcinoma (mRCC). There are nomograms to assist in clinical decision-making and inform patients of their disease progression. However, they have a limited capacity and moderate concordance rates. Performance status (PS) is one of the most widely used prognostic factors and most closely related to overall survival (OS), but this is a subjective assessment based solely on the clinician’s opinion. Patients must be at the center of care. Patient-reported outcomes (PROs) have shown benefits but are not widespread in daily clinical practice.

Methods

We analyzed 78 consecutive patients diagnosed with mRCC who initiated treatment at our institution between September 2012 and September 2019. We performed a descriptive analysis of the sample’s baseline characteristics and the NCCN FKSI 19 questionnaire. We also conducted a survival analysis.

Results

The baseline FKSI 19 score demonstrates its prognostic potential, HR of 0.94 (95% CI 0.92–0.97). Our prognostic model would include: FKSI < 58 (HR 3.61 95% CI 1.97–6.61), anemia, thrombocytosis, non-clear cell histology, and metastatic hepatic involvement. AUC 0.86 (95%CI 0.77–0.95).

Conclusion

Although it would need external validation, the proposed nomogram could be an alternative to other previously described models. The NCCN FKSI 19 baseline score could replace the clinician’s subjective determination of PS.

Clinical trial registration

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Urology and Nephrology Department, Oncologic Urology Unit, University Hospital Virgen del Rocío, Av. Manuel Siurot, S/n, 41013, Seville, Spain

    Guillermo Lendínez-Cano, Belen Congregado-Ruíz & Rafael Medina-López

  2. Biomedical Institute of Seville (IBiS), University Hospital Virgen del Rocío, CSIC, University of Seville, Seville, Spain

    Guillermo Lendínez-Cano, Belen Congregado-Ruíz & Rafael Medina-López

  3. Preventive Medicine and Public Health Department, Seville University, Seville, Spain

    Ángel Vilches-Arenas

Authors
  1. Guillermo Lendínez-Cano
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  2. Ángel Vilches-Arenas
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  3. Belen Congregado-Ruíz
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  4. Rafael Medina-López
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All authors have approved the final submitted manuscript and agreed both to be personally accountable for the author’s contributions and to ensure that matters related to the accuracy or integrity of any part of this work, even those in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

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Correspondence to Guillermo Lendínez-Cano.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethics approval and patient consent

This study has been conducted according to the ethical principles governing medical research in human subjects (Declaration of Helsinki by the World Medical Association (WMA) updated in 2013 in Fortaleza City). This study was approved on November 28th, 2019, by the Ethics Committee of our institution.

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Lendínez-Cano, G., Vilches-Arenas, Á., Congregado-Ruíz, B. et al. Patient's self-reported quality of life as a prognostic factor in metastatic renal cell carcinoma initially treated with TKI: nomogram proposal. World J Urol 42, 267 (2024). https://doi.org/10.1007/s00345-024-04972-9

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