Objective To investigate the impact of multiorgan metastases on the survival prognosis of patients with renal cell carcinoma （RCC）and to develop a nomogram prediction model for clinical diagnosis and treatment. Methods A retrospective analysis of 3038 metastatic RCC patients from the SEER database （2010-2015） was conducted to evaluate the effects of multiorgan metastases on prognosis. Further analysis was conducted on 1,013 patients with multiorgan metastasis, and they were randomly divided into a modeling group and a validation group at a ratio of 7:3. Univariate and multivariate Cox regression analysis identified independent factors influencing overall survival （OS） in the modeling group,which were then used to develop a nomogram model. The predictive performance of the nomogram was assessed using the C-index, ROC curves,and calibration curves. A risk stratification system was also created based on the nomogram. Results Patients with multi~organ metastases had poorer outcomes （HR=1.82, 95% CI： 1.68-1.97）. Multivariate analysis identified several risk factors：papillary RCC （HR=0.95, 95% CI： 0.68-1.35）, other histologies （HR=2.09, 95% CI： 1.71-2.56）, Grade III-IV （HR=1.23, 95% CI： 0.96-1.58）, N1 stage （HR=1.46, 95% CI： 1.24-1.72）, brain metastases （HR=1.24, 95% CI： 1.04-1.49）, and liver metastases （HR=1.26, 95% CI： 1.07-1.48）, while surgery （HR=0.44, 95% CI： 0.36-0.55） and chemotherapy （HR=0.58, 95% CI： 0.49-0.69） were protective factors. Based on these factors, a nomogram model for predicting 1year, 3year, and 5year OS of patients was constructed. The nomogram demonstrated strong predictive accuracy,supported by C-index,ROC,and calibration curve analyses. The risk stratification system effectively differentiated patient risk groups. Conclusions This study successfully constructed a nomogram prognostic model for patients with multi~organ metastasis of renal cell carcinoma, with good verification results, and can provide certain assistance for clinical diagnosis and treatment.
Key words
renal cell carcinoma /
nomogram /
prognosis /
multi-organ metastasis /
SEER
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