Prognostic Factors Analysis And Nomogram Prognostic Model Construction Of Non-metastatic Synchronous Bilateral Renal Cell Carcinoma

BACKGROUND&OBJECTIVE:Renal cell carcinoma(RCC)is one of the most common malignant tumors of urinary system,the mortality rate ranks first in urinary system malignancies.Most of the renal cell carcinoma patients are unilaterally.Bilateral renal cell carcinoma cases account for only 5%-10%of all renal cell carcinoma patients,of which synchronous bilateral renal malignant tumor cases are the most common.As a rare situation in renal malignant tumors,the current research on synchronous bilateral renal malignant tumors is still very limited,whether its survival prognosis is consistent with unilateral renal tumors or not,and which factors may affect the postoperative survival of patients are not clear.The aim of this study is to investigate which independent prognostic factors exist in non-metastatic synchronous bilateral renal cell carcinoma,and to construct a prognostic model that can predict the postoperative survival of patients according to these independent prognostic factors,so as to provide guidance for the return visit and follow-up of patients with non-metastatic synchronous bilateral renal cell carcinoma after surgery.Methods:In In this study,the clinical data of patients with non-metastatic synchronous bilateral renal cell carcinoma from 2010 to 2015 in SEER database were used as the training cohort(554 cases).After matching the relevant prognostic factors by propensity score matching,the postoperative 5-year survival rates of patients with non-metastatic synchronous bilateral renal cell carcinoma and non-metastatic unilateral renal cell carcinoma and the difference in postoperative 5-year survival rates between patients with non-metastatic synchronous bilateral renal cell carcinoma were compared.Univariate and multivariate Cox regression analyses were performed for prognostic factors in patients with non-metastatic synchronous bilateral renal cell carcinoma to screen independent prognostic factors for non-metastatic synchronous bilateral renal cell carcinoma,and nomogram prognostic models were constructed based on these independent prognostic factors.The above results were also verified by the validation cohort(111 cases)which data of patients with non-metastatic synchronous bilateral renal cell carcinoma who were hospitalized for surgical treatment between January 2007 and November 2021 in the General Hospital of Eastern Theater Command and Qilu Hospital.Results:1.There was no significant difference in 5-year postoperative survival rate between patients with non-metastatic simultaneous bilateral renal cell carcinoma and patients with non-metastatic unilateral renal cell carcinoma.2.Patients underwent bilateral partial nephrectomy have a better prognosis when compared with underwent radical nephrectomy for at least one side in non-metastatic synchronous bilateral renal cell carcinoma.3.Age>=60 years,clinical stage Ⅲ and Ⅳ,Sarcomatoid features on histopathology,Fuhrman or WHO/ISUP nuclear grade Ⅲ and Ⅳ,and radical nephrectomy on at least one side at initial diagnosis are independent risk factors for postoperative survival of non-metastatic bilateral renal cell carcinoma patients.4.The nomogram prognostic model predicted 5-year overall survival(OS)of bilateral renal cell carcinoma patients that constructed based on the above independent prognostic factors has good predictive power(training cohort internal validation:C-index=0.763,validation cohort external validation:C-index=0.918)...