Editing Metastatic Kidney Cancer (section)

== Prognostic factors in Metasatic RCC ==

* '''2 prognostic models have been developed: Motzer and Heng criteria'''

=== Motzer criteria ===

* '''Developed in''' 463 '''patients with advanced kidney cancer (stage IV) of any histology treated with interferon (IFN)-α as the first-line systematic therapy[https://pubmed.ncbi.nlm.nih.gov/11773181/ §]'''
* '''Variables significantly associated with decreased overall survival (5):'''
*# '''<span style="color:#ff0000">Karanofsky performance status (<80)'''
*# '''<span style="color:#ff0000">Interval from diagnosis to treatment (<1 year)'''
*# '''<span style="color:#ff0000">Hemoglobin (< lower limit of normal)'''
*# '''<span style="color:#ff0000">Corrected Calcium (>10 g/dL)'''
*# '''<span style="color:#ff0000">Lactate dehydrogenase (>1.5x the upper limit of normal)'''
* '''<span style="color:#ff0000">Stratified into 3 risk groups based on the number of risk factors present:'''
** '''<span style="color:#ff0000">Favourable-risk: 0 risk factors</span>'''; median survival 30 months
** '''<span style="color:#ff0000">Intermediate-risk: 1-2 risk factors</span>'''; median survival 14 months
** '''<span style="color:#ff0000">Poor-risk: ≥3 risk factors</span>'''; median survival 5 months

=== Heng (IMDC) criteria ===
* The use of targeted therapy for advanced kidney cancer has displaced immunotherapy as the first-line systemic treatment due to improved survival and better tolerability
* Heng et al. subsequently '''developed a prognostic model''' '''in''' 645 '''patients with advanced kidney cancer of any histology treated with targeted (anti-vascular endothelial growth factor) therapy as the first-line systematic therapy'''
* '''<span style="color:#ff0000">6 variables significantly associated with overall survival K-PINCH:</span>'''
** '''<span style="color:#ff0000">4 of the Motzer criteria (without lactate dehydrogenase)</span>'''
** '''<span style="color:#ff0000">Neutrophil count (> upper limit of normal)</span>'''
** '''<span style="color:#ff0000">Platelets (> upper limit of normal)</span>'''
* '''<span style="color:#ff0000">Stratified into 3 risk groups based on number of risk factors present:</span>'''
** '''<span style="color:#ff0000">Favourable-risk: 0 risk factors</span>'''; median survival not reached
** '''<span style="color:#ff0000">Intermediate-risk: 1-2 risk factors</span>'''; median survival 27 months
** '''<span style="color:#ff0000">Poor-risk: ≥3 risk factors</span>'''; median survival 9 months