The SSIGN score for renal cell carcinoma evaluates the severity of the disease based on six clinical and pathological criteria: T stage, N stage, M stage, tumor size, tumor nuclear grade, and tumor necrosis. Each criterion is assigned a numerical score according to specified response categories. The total score provides an estimate of the 5-year cancer-specific survival rate, with higher scores indicating poorer prognosis.

The scoring system assigns values as follows:
- T Stage: pT1 = 0, pT2 = 1, pT3a-c = 2, pT4 = 3
- N Stage: pNx = 0, pN0 = 0, pN1 = 2, pN2 = 2
- M Stage: M0 = 0, M1 = 4
- Tumor Size: < 5 cm = 0, >= 5 cm = 2
- Tumor Nuclear Grade: 1-2 = 0, 3 = 1, 4 = 3
- Tumor Necrosis: Absent = 0, Present = 2

To compute the total score, each of the inputs is mapped to its corresponding score value. These values are summed to yield a total score between 0 and 16. The interpretation of the total score is based on survival likelihood estimates:

- Scores 0 to 1: Estimated 5-year cancer-specific survival is 99.4%
- Score 2: Estimated 5-year cancer-specific survival is 94.8%
- Score 3: Estimated 5-year cancer-specific survival is 87.8%
- Score 4: Estimated 5-year cancer-specific survival is 79.1%
- Score 5: Estimated 5-year cancer-specific survival is 65.4%
- Score 6: Estimated 5-year cancer-specific survival is 54%
- Score 7: Estimated 5-year cancer-specific survival is 41%
- Score 8: Estimated 5-year cancer-specific survival is 23.6%
- Score 9: Estimated 5-year cancer-specific survival is 19.6%
- Scores 10 or higher: Estimated 5-year cancer-specific survival is 7.4%

The SSIGN Score, or the Stage, Size, Grade, and Necrosis Score, is a prognostic calculator specifically designed for patients with renal cell carcinoma (RCC). This scoring system is used to predict the survival rate of patients with RCC after undergoing nephrectomy. It takes into account the tumor stage, tumor size, Fuhrman grade, and the presence of tumor necrosis. The SSIGN score helps clinicians to stratify patients into different risk groups and guide treatment decisions. It is not applicable to patients with non-renal cell carcinoma or those who have not undergone nephrectomy.

SSIGN score for renal cell carcinoma

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.