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Mekhail Extension of the Motzer Score

Extends the MSKCC/Motzer model with prior radiotherapy and metastatic site count for metastatic RCC.

Mekhail Extension of the Motzer Score
Time from diagnosis to treatment <1 year
LDH above the upper limit of normal
Hemoglobin below the lower limit of normal
Corrected serum calcium >10 mg/dL
Prior radiotherapy
≥2 sites of metastasis (e.g., lung, liver, retroperitoneal nodes)
Result0 factors

Favorable risk — median overall survival ~26.0 months.

Risk group
Favorable risk
Median overall survival
~26.0 months

When to use

  • Prognosticating previously untreated metastatic renal cell carcinoma using an expanded set of six clinical factors validated in an independent cohort.

Formula

Count of: time diagnosis-to-treatment <1y, elevated LDH, low hemoglobin, corrected calcium >10 mg/dL, prior radiotherapy, and ≥2 metastatic sites. Favorable 0-1 factors, intermediate 2, poor >2.

Pearls and pitfalls

  • Extends the original 5-factor Motzer/MSKCC model; performance status was not retained as independent in this validation cohort, while prior radiotherapy and multi-site metastasis were added.

References

  1. Mekhail TM, et al. J Clin Oncol. 2005;23(4):832-841.