武警医学2025，Vol.36Issue(7)：605-611,7.
多器官转移肾细胞癌患者的预后模型的构建和验证
Construction and validation of a prognostic model for patients with multi-organ metasta-sis in renal cell carcinoma
摘要
Abstract
Objective To investigate the impact of multi‑organ metastases on the survival prognosis of patients with renal cell carcinoma(RCC)and to develop a nomogram prediction model for clinical diagnosis and treatment.Methods A retrospective analysis of 3038 metastatic RCC patients from the SEER database(2010-2015)was conducted to evaluate the effects of multi‑organ metastases on prognosis.Further analysis was conducted on 1,013 patients with multi‑organ metastasis,and they were randomly divided into a mod‑eling group and a validation group at a ratio of 7:3.Univariate and multivariate Cox regression analysis identified independent factors in‑fluencing overall survival(OS)in the modeling group,which were then used to develop a nomogram model.The predictive performance of the nomogram was assessed using the C‑index,ROC curves,and calibration curves.A risk stratification system was also created based on the nomogram.Results Patients with multi～organ metastases had poorer outcomes(HR=1.82,95％CI:1.68–1.97).Multivariate analysis identified several risk factors:papillary RCC(HR=0.95,95％CI:0.68-1.35),other histologies(HR=2.09,95％CI:1.71-2.56),Grade III-IV(HR=1.23,95％CI:0.96-1.58),N1 stage(HR=1.46,95％CI:1.24-1.72),brain metasta‑ses(HR=1.24,95％CI:1.04–1.49),and liver metastases(HR=1.26,95％CI:1.07-1.48),while surgery(HR=0.44,95％CI:0.36-0.55)and chemotherapy(HR=0.58,95％CI:0.49-0.69)were protective factors.Based on these factors,a nomogram model for predicting 1‑year,3‑year,and 5‑year OS of patients was constructed.The nomogram demonstrated strong predictive accuracy,sup‑ported by C‑index,ROC,and calibration curve analyses.The risk stratification system effectively differentiated patient risk groups.Conclusions This study successfully constructed a nomogram prognostic model for patients with multi～organ metastasis of renal cell carcinoma,with good verification results,and can provide certain assistance for clinical diagnosis and treatment.关键词
肾癌/列线图/预后/多器官转移/SEERKey words
renal cell carcinoma/nomogram/prognosis/multi‑organ metastasis/SEER分类
医药卫生引用本文复制引用
吴芸冰,胡有根,刘广,单唯远,汤元杰..多器官转移肾细胞癌患者的预后模型的构建和验证[J].武警医学,2025,36(7):605-611,7.基金项目
扬州市十三五科教强卫领军人才(创新团队)资助项目(扬卫科教[2018]6号) （创新团队）
