UCLA Integrated Staging System (UISS) for Renal Cell Carcinoma (RCC)

UCLA Integrated Staging System (UISS) for RCC

T Stage (Pathological)

Fuhrman Nuclear Grade

ECOG Performance Status

UISS Risk: –

Awaiting input

Select all 3 parameters.

Provides 5-year disease-free prognosis for localized and metastatic RCC.

Why Use

There are no validated scoring systems for predicting survival in mRCC. Using a score may help sketch categories of survival time better than clinical judgment alone.

When to Use

Patients with RCC, localized or metastatic, particularly those being considered for clinical trial enrollment.

Formula

Addition of the selected points: Localized disease (Any T, N0M0) T stage Nuclear grade ECOG PS Risk T1 Fuhrman 1-2 0 Low ≥1 Intermediate Fuhrman 3-4 Any T2 Any Any T3 Fuhrman 1 0 ≥1 Fuhrman >1 0 ≥1 High Metastatic disease (N1, N2, or M1) N/M stage Nuclear grade ECOG PS Risk N1M0 Any Any Low N2M0/M1 Fuhrman 1 0 Low ≥1 Intermediate Fuhrman 2 0 Low ≥1 Intermediate Fuhrman 3 Any Fuhrman 4 0 ≥1 High

Pearls / Pitfalls

This score placed patients with local or metastatic renal cell carcinoma (mRCC) into mortality risk groups: low, intermediate/moderate, and high. The derivation and numerous external validations have been chart reviews, though all find orderly progressions in 5-year survival based on group. Prospective validation is eagerly awaited, and we know of no validations including substantial numbers of patients treated with modern targeted VEGF therapy.

Management

We are unaware of validated management algorithms using the score.

Critical Actions

The UISS score is complex, requiring close attention to multiple variables for correct classification.

Advice

The UISS score is often used for screening and stratifying patients into modern therapy trials, including trials of VEGF therapy such as sunitinib. The consistency of results in validation studies is somewhat reassuring, and one advantage is its applicability to patients with and without metastatic disease.

More Information

Disease Type Risk Group Five-year disease-specific survival Local Disease Low 91.1% Intermediate 80.4% High 54.7% Metastatic Disease Low 32% Intermediate 19.5% High 0%