The SSPN Score, a Novel Scoring System Incorporating PBRM1 Expression, Predicts Postoperative Recurrence for Patients wi
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ORIGINAL ARTICLE – UROLOGIC ONCOLOGY
The SSPN Score, a Novel Scoring System Incorporating PBRM1 Expression, Predicts Postoperative Recurrence for Patients with Non-metastatic Clear Cell Renal Cell Carcinoma Haruyuki Ohsugi1, Takashi Yoshida1, Chisato Ohe2, Junichi Ikeda1, Motohiko Sugi1, Hidefumi Kinoshita1, Koji Tsuta2, and Tadashi Matsuda1 1
Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan; 2Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan
ABSTRACT Background. The loss of PBRM1 expression (as identified by immunohistochemistry) is associated with a high risk of postoperative recurrence for patients with clear cell renal cell carcinoma (ccRCC). The authors developed a scoring system to predict recurrence based on clinicopathologic factors incorporating PBRM1 expression. Methods. This study retrospectively reviewed 479 ccRCC patients who underwent radical surgery between 2006 and 2017. The study extracted a subset of 389 non-metastatic ccRCC patients for whom relevant clinicopathologic factors were available. The primary end point was recurrencefree survival (RFS). The Kaplan–Meier method and the Cox proportional hazards model were used for statistical analysis. Leibovich score, SSIGN score, and University of California, Los Angeles (UCLA) Integrated Staging System were included as conventional prediction models. Results. Of the 389 patients, 53 (13.6%) experienced recurrence during a median period of 61 months. Multivariable analyses showed that that the independent factors for RFS were C pT3 (hazard ratio [HR] 3.64; P \ 0.001), sarcomatoid or rhabdoid component (HR 3.29; P = 0.005),
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-09075-4) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 19 March 2020 Accepted: 7 July 2020 T. Matsuda e-mail: [email protected]
PBRM1 negativity (HR 3.39; P = 0.001), and necrosis (HR 3.60; P \ 0.001). A scoring system calculated with these factors, named the SSPN (stage, sarcomatoid, PBRM1 expression, and necrosis) score, showed significant differences in RFS among the following four groups; low-risk group (0 factors), intermediate-risk group (1 factor), highrisk group (2 to 3 factors), and very high-risk group (4 factors) (P \ 0.001). The authors’ model also showed a greater predictive accuracy for 5-year RFS than the conventional models (0.841 vs 0.747–0.792). Conclusions. The SSPN score, which integrates clinicopathologic findings and PBRM1 expression, can accurately predict postoperative recurrence for patients with nonmetastatic ccRCC after radical surgery.
Renal cell carcinoma (RCC) is newly diagnosed for an estimated 403,000 people and causes approximately 175,000 deaths annually.1 Clear cell renal cell carcinoma (ccRCC), the predominant histologic subtype of kidney cancer, accounts for approximately 75% of RCCs.2 Surgical resection, such as radical or part
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