External Validation of the GRade, Age, Nodes and Tumor (GRANT) Score for Patients with Surgically Treated Papillary Renal Cell Carcinoma

Introduction Stratifying the risk of recurrence for surgically treated papillary renal cell carcinoma (pRCC) could be challenging. Prognostic models are crucial for patient counselling and individualized surveillance. The GRANT score is one of the models suggested by guidelines to predict prognosis...

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Main Authors: Michele Maffezzoli MD, Alessio Signori MD, Davide Campobasso MD, Giulia Claire Giudice MD, Nicola Simoni MD, Massimo De Filippo MD, Enrico Maria Silini MD, Sebastiano Buti MD, PhD
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Technology in Cancer Research & Treatment
Online Access:https://doi.org/10.1177/15330338251329848
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author Michele Maffezzoli MD
Alessio Signori MD
Davide Campobasso MD
Giulia Claire Giudice MD
Nicola Simoni MD
Massimo De Filippo MD
Enrico Maria Silini MD
Sebastiano Buti MD, PhD
author_facet Michele Maffezzoli MD
Alessio Signori MD
Davide Campobasso MD
Giulia Claire Giudice MD
Nicola Simoni MD
Massimo De Filippo MD
Enrico Maria Silini MD
Sebastiano Buti MD, PhD
author_sort Michele Maffezzoli MD
collection DOAJ
description Introduction Stratifying the risk of recurrence for surgically treated papillary renal cell carcinoma (pRCC) could be challenging. Prognostic models are crucial for patient counselling and individualized surveillance. The GRANT score is one of the models suggested by guidelines to predict prognosis of surgically treated pRCC. This study aims to externally validate the GRANT score using a three-risk group stratification in a large cohort of pRCC patients. Materials and Methods The present analysis utilized retrospective data from pRCC patients who underwent radical or partial nephrectomy. The GRANT score parameters included tumor grade, age, pathological T-stage, and N-stage. Patients were stratified into three risk groups (0-1 vs 2 vs 3-4 risk factors). Cancer-specific survival (CSS) was assessed using the Kaplan-Meier method, and differences between groups were evaluated using the log-rank test. Harrell's c-index was used to measure model accuracy, and restricted mean survival time (RMST) was calculated for up to 120 months. Results A total of 1942 patients were included. The median follow-up was 64.6 months. At 60 months, CSS was 93.2% (95%CI 91.7%-94.6%) for group 1, 60.8% (95%CI 54.0%-78.6%) for group 2, and 26% (95%CI 15.7%-42.9%) for group 3, with significant differences between each group (p < 0.001). The median CSS was not reached for group 1 (95%CI NR-NR), 86.0 months in group 2 (95%CI 65-NR), and 22.8 months in group 3 (95%CI 16.4-48.0). The c-index for CSS was 0.732. The RMST at 120 months was 113.3 months for group 1, 75.9 months for group 2, and 56.6 months for group 3, with a statistically significant difference (p < 0.001). Conclusion The GRANT score effectively stratified surgically treated pRCC patients into three risk groups, demonstrating good prognostic accuracy. This validation supports the GRANT score's utility as a reliable and easy-to-use prognostic tool.
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spelling doaj-art-97fc2d74d1b549cdb24d39f4537be7862025-08-20T02:42:00ZengSAGE PublishingTechnology in Cancer Research & Treatment1533-03382025-03-012410.1177/15330338251329848External Validation of the GRade, Age, Nodes and Tumor (GRANT) Score for Patients with Surgically Treated Papillary Renal Cell CarcinomaMichele Maffezzoli MD0Alessio Signori MD1Davide Campobasso MD2Giulia Claire Giudice MD3Nicola Simoni MD4Massimo De Filippo MD5Enrico Maria Silini MD6Sebastiano Buti MD, PhD7 Medicine and Surgery Department, , Parma, Italy Section of biostatistics, Department of Health Sciences (DISSAL), , Genova, Italy Department of Urology, , Parma, Italy Medicine and Surgery Department, , Parma, Italy Radiotherapy Unit, , Parma, Italy Department of Medicine and Surgery, Section of Radiology, , Parma, Italy Pathology Unit, , Parma, Italy Medical Oncology Unit, , Parma, ItalyIntroduction Stratifying the risk of recurrence for surgically treated papillary renal cell carcinoma (pRCC) could be challenging. Prognostic models are crucial for patient counselling and individualized surveillance. The GRANT score is one of the models suggested by guidelines to predict prognosis of surgically treated pRCC. This study aims to externally validate the GRANT score using a three-risk group stratification in a large cohort of pRCC patients. Materials and Methods The present analysis utilized retrospective data from pRCC patients who underwent radical or partial nephrectomy. The GRANT score parameters included tumor grade, age, pathological T-stage, and N-stage. Patients were stratified into three risk groups (0-1 vs 2 vs 3-4 risk factors). Cancer-specific survival (CSS) was assessed using the Kaplan-Meier method, and differences between groups were evaluated using the log-rank test. Harrell's c-index was used to measure model accuracy, and restricted mean survival time (RMST) was calculated for up to 120 months. Results A total of 1942 patients were included. The median follow-up was 64.6 months. At 60 months, CSS was 93.2% (95%CI 91.7%-94.6%) for group 1, 60.8% (95%CI 54.0%-78.6%) for group 2, and 26% (95%CI 15.7%-42.9%) for group 3, with significant differences between each group (p < 0.001). The median CSS was not reached for group 1 (95%CI NR-NR), 86.0 months in group 2 (95%CI 65-NR), and 22.8 months in group 3 (95%CI 16.4-48.0). The c-index for CSS was 0.732. The RMST at 120 months was 113.3 months for group 1, 75.9 months for group 2, and 56.6 months for group 3, with a statistically significant difference (p < 0.001). Conclusion The GRANT score effectively stratified surgically treated pRCC patients into three risk groups, demonstrating good prognostic accuracy. This validation supports the GRANT score's utility as a reliable and easy-to-use prognostic tool.https://doi.org/10.1177/15330338251329848
spellingShingle Michele Maffezzoli MD
Alessio Signori MD
Davide Campobasso MD
Giulia Claire Giudice MD
Nicola Simoni MD
Massimo De Filippo MD
Enrico Maria Silini MD
Sebastiano Buti MD, PhD
External Validation of the GRade, Age, Nodes and Tumor (GRANT) Score for Patients with Surgically Treated Papillary Renal Cell Carcinoma
Technology in Cancer Research & Treatment
title External Validation of the GRade, Age, Nodes and Tumor (GRANT) Score for Patients with Surgically Treated Papillary Renal Cell Carcinoma
title_full External Validation of the GRade, Age, Nodes and Tumor (GRANT) Score for Patients with Surgically Treated Papillary Renal Cell Carcinoma
title_fullStr External Validation of the GRade, Age, Nodes and Tumor (GRANT) Score for Patients with Surgically Treated Papillary Renal Cell Carcinoma
title_full_unstemmed External Validation of the GRade, Age, Nodes and Tumor (GRANT) Score for Patients with Surgically Treated Papillary Renal Cell Carcinoma
title_short External Validation of the GRade, Age, Nodes and Tumor (GRANT) Score for Patients with Surgically Treated Papillary Renal Cell Carcinoma
title_sort external validation of the grade age nodes and tumor grant score for patients with surgically treated papillary renal cell carcinoma
url https://doi.org/10.1177/15330338251329848
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