Construction and validation of a prognostic prediction model for T1/T2 stage renal cell carcinoma patients treated with robot-assisted laparoscopic partial nephrectomy
Che Shiqing
Huang Yuanyuan
Bai Yaxin
Zhang Xue
Zhang Chengwei
Abstract：Objective To construct and validate a prognostic prediction model for T1/T2 stage renal carcinoma patients treated with robot-assisted laparoscopic partial nephrectomy(RALPN).Methods A total of 400 patients with T1/T2 stage renal carcinoma who underwent RALPN at the Affiliated Hospital of Nanjing University Medical School from August 2018 to July 2019 were retrospectively enrolled.A nomogram prediction model for prognosis was constructed,and internal validation was performed using the Bootstrap method,with calibration curves drawn for consistency verification.Results Among the 400 patients,22 were lost to follow-up at 5 years,and 378 completed effective follow-up.The 5-year cumulative survival rate was 90.5％(342/378),including 342 in the survival group and 36(9.5％)deaths in the death group.Cox regression analysis showed that increased differentiation degree was an independent protective factor for the prognosis of RALPN patients,while older age,presence of clinical symptoms,elevated World Health Organization(WHO)/International Society of Urological Pathology(ISUP)grade,advanced T stage,and regional lymph node metastasis were independent risk factors(all P＜0.05).A prognostic risk prediction model was constructed based on the above results.Hosmer-Lemeshow goodness-of-fit test showedx2=6.762,degree of freedom=8,P=0.578.The nomogram prediction model revealed that the influencing factors on prognosis ranked as age,WHO/ISUP grade,differentiation degree,T stage,clinical symptoms,and regional lymph node metastasis.When the total score reached 156,the 5-year mortality rate could reach 85.0％.The concordance index of the nomogram model was 0.956,indicating good consistency between predicted prognostic risk and actual risk in RALPN patients.The Brier score was 0.076,and the calibration slope was 0.820.Conclusion Prognostic factors for T1/T2 stage renal carcinoma patients treated with RALPN include differentiation degree,age,clinical symptoms,WHO/ISUP grade,T stage,and regional lymph node metastasis.The prediction model constructed based on these factors shows favorable discrimination and calibration.
Keywords：Renal carcinomaRobot-assisted laparoscopic partial nephrectomyPrediction model
Publication Date：2026-07-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1031-1035 )