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In this retrospective study conducted at various hospitals in Italy, the GRANT (GRade, Age, Nodes, and Tumour) and the UISS (University of California Los Angeles Integrated Staging System) scores were compared in 134 patients with renal cell carcinoma (RCC) who had a nephrectomy. These scores are used to predict outcomes in patients with localised RCC.
The GRANT score is based on four features: the grade of the tumour, the patient’s age, whether the cancer had spread to the lymph nodes, and the stage of the tumour. Each factor is worth 0 or 1, and they are summed into two risk categories: favourable (0–1) and unfavourable (≥2). Both the GRANT score and the UISS score can be used in clinical practice to predict the risk of recurrence after nephrectomy in patients with localised RCC.
The patients were followed for a median time of 96 months. The median disease-free survival of the overall study population was 53.7 months. Both the GRANT and UISS scores had comparable disease-free survival. The median disease-free survival for favourable and unfavourable GRANT scores were 84.9 and 38.4 months, respectively. The median disease-free survival for low, intermediate, and high risk of recurrence according to the UISS score were 92.3, 51.7, and 49.8 months, respectively
In summary, this study describes a new predictive GRANT score for disease-free survival in post-nephrectomy RCC patients. This score was developed from trials with interleukin-2 and interferon-alpha and validated in the ASSURE trial. Other scoring systems, including the Mayo Clinic SSIGN, the Leibovich score, and the UISS have been developed to predict recurrence and are only used in clinical trials. The GRANT score needs further testing before routine clinical use.