The Cardiovascular
ToolsCalculators

IMDC Risk Model for Metastatic Renal Cell Carcinoma

Six-factor (Heng) model stratifying survival in metastatic RCC treated with systemic therapy.

IMDC Risk Model for Metastatic Renal Cell Carcinoma
Karnofsky performance status <80%
Time from diagnosis to systemic treatment <1 year
Hemoglobin below the lower limit of normal
Corrected serum calcium above the upper limit of normal
Absolute neutrophil count above the upper limit of normal
Platelet count above the upper limit of normal
Result0 factors

Favourable-risk group; reported median overall survival ~43.2 months on systemic therapy.

IMDC risk group
Favourable
Median overall survival
~43.2 months

When to use

  • Stratifying expected survival and informing first-line systemic therapy choice in metastatic renal cell carcinoma.

Formula

One point each for: KPS <80%, time from diagnosis to treatment <1 year, anemia, hypercalcemia, neutrophilia, thrombocytosis (all relative to laboratory normal ranges). Favourable = 0, Intermediate = 1-2, Poor = 3-6.

Pearls and pitfalls

  • Also known as the Heng criteria; validated across multiple targeted-therapy and immunotherapy eras.
  • Median overall survival figures reflect the externally validated, population-based cohort (Heng et al. 2013); the original 2009 derivation cohort reported a median not reached (favourable), 27 months (intermediate), and 8.8 months (poor).

References

  1. Heng DY, Xie W, Regan MM, et al. J Clin Oncol. 2009;27(34):5794-9.
  2. Heng DY, Xie W, Regan MM, et al. Lancet Oncol. 2013;14(2):141-8.