ToolsCalculators
SSIGN Score for Renal Cell Carcinoma (RCC)
Postoperative prognosis for clear cell renal cell carcinoma after nephrectomy.
SSIGN Score for Renal Cell Carcinoma (RCC)
Primary tumor stage (pT)
Regional lymph nodes (pN)
Distant metastasis (M)
Tumor size
Nuclear (Fuhrman) grade
Histologic (coagulative) tumor necrosis
Result0 points
Approximates low risk for cancer-specific death, with 5-year cancer-specific survival of about ~95-97 %.
- Risk group
- low risk
- Approx. 5-year cancer-specific survival
- ~95-97 %
When to use
- Postoperative risk stratification for cancer-specific survival after radical (or partial) nephrectomy for clear cell RCC.
- Selecting patients for surveillance intensity or clinical trials of adjuvant therapy.
Formula
SSIGN = points for pT stage (pT1=0, pT2=1, pT3=3, pT4=4) + pN stage (N0/Nx=0, N1=2) + M stage (M0=0, M1=4) + tumor size (<10cm=0, >=10cm=1) + nuclear grade (1-2=0, 3=1, 4=3) + coagulative necrosis (absent=0, present=1).
Pearls and pitfalls
- Developed and validated at Mayo Clinic specifically for clear cell histology; not intended for papillary or chromophobe RCC.
- Remains predictive with long-term follow-up and in contemporary partial-nephrectomy cohorts, though absolute survival at a given score has improved over time with better systemic therapy.
References
- Frank I, Blute ML, Cheville JC, et al. An outcome prediction model for patients with clear cell renal cell carcinoma treated with radical nephrectomy based on tumor stage, size, grade and necrosis: the SSIGN score. J Urol. 2002;168(6):2395-2400.
- Parker WP, Cheville JC, Frank I, et al. Application of the SSIGN Score for Clear Cell Renal Cell Carcinoma in Contemporary Patients. Eur Urol. 2017;71(4):665-673.