External Validation of the ASSURE Model for Predicting Oncological Outcomes After Resection of High-risk Renal Cell Carcinoma (RESCUE Study: UroCCR 88).
Fiche publication
Date publication
novembre 2021
Journal
European urology open science
Auteurs
Membres identifiés du Cancéropôle Est :
Dr BARTHELEMY Philippe
Tous les auteurs :
Khene ZE, Larcher A, Bernhard JC, Doumerc N, Ouzaid I, Capitanio U, Nouhaud FX, Boissier R, Rioux-Leclercq N, De La Taille A, Barthelemy P, Montorsi F, Rouprêt M, Bigot P, Bensalah K,
Lien Pubmed
Résumé
A prognostic model based on the population of the ASSURE phase 3 trial has recently been described. The ASSURE model stratifies patients into risk groups to predict survival after surgical resection of intermediate- and high-risk localised kidney cancer. We evaluated this model in an independent cohort of 1372 patients using discrimination, calibration, and decision curve analysis. Regarding disease-free survival, the ASSURE model showed modest discrimination (65%), miscalibration, and poor net benefit compared with the UCLA Integrated Staging System (UISS) and Leibovich 2018 models. Similarly, the ability of the ASSURE model to predict overall survival was poor in terms of discrimination (63%), with overestimation on calibration plots and a modest net benefit for the probability threshold of between 10% and 40%. Overall, our results show that the performance of the ASSURE model was less optimistic than expected, and not associated with a clear improvement in patient selection and clinical usefulness in comparison to with available models. We propose an updated version using the recalibration method, which leads to a (slight) improvement in performance but should be validated in another external population.
Mots clés
External validation, Kidney cancer, Nephrectomy, Prognosis, Risk groups, Survival
Référence
Eur Urol Open Sci. 2021 Nov;33:89-93