PURPOSE: We assessed whether supplementing the Leibovich prognosis score with vascular invasion would improve prognostic value to predict @entity3 in @entity1 with nonmetastatic @entity1358 . MATERIALS AND METHODS: We retrospectively evaluated the pathology records of 1,754 @entity1 with nonmetastatic @entity1358 treated with surgery between 1984 and 2006 at a single tertiary academic center. The Leibovich prognosis score was supplemented by additional scoring for vascular invasion. @entity3 -free survival was assessed using the Kaplan-Meier method for each score category. A Cox regression model was used for multivariate testing. Predictive accuracy was determined by the Harrell concordance index and decision curve analysis. RESULTS: Median followup was 84 months. Ten-year metastasis-free survival probability for a score of 0 to 1 and 2 to 8 or greater was 95%, 83%, 78%, 81%, 69%, 51%, 15% and 13%, respectively. The concordance index was 0.792 compared to 0.778 from our external validation of the Leibovich prognosis score using routine pathological findings (p <0.05). Decision curve analysis also favored the predictive ability of the novel model. CONCLUSIONS: Adding vascular invasion improved the predictive accuracy of our validation data by 1.4% over that of the Leibovich prognosis score. @entity1 with a score of 7 or greater had a more than 85% probability of @entity3 at 10 years. Thus, they could be considered candidates for adjuvant treatment trials.

Prognostic value of the Leibovich prognosis score supplemented by vascular invasion for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1358 :: ('MESH:D002292', 'Disease') :: ['clear cell renal cell carcinoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['Metastasis', 'metastatic disease']
@entity1358 :: (MESH:D002292,Disease) :: ['clear cell renal cell carcinoma']
