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Memorial Sloan-Kettering Cancer Center (MSKCC/Motzer) Score for Metastatic Renal Cell Carcinoma (RCC)

Memorial Sloan-Kettering Cancer Center (MSKCC/Motzer) Score predicts prognosis of survival rate of metastatic renal cell carcinoma.
Time from diagnosis to systemic treatment <1 year
Measured ~1 month after stopping anticoagulation
No 0
Yes 1
Hemoglobin < Lower Limit of Normal
Men (Normal): 13.5-17.5 g/dL | Women (Normal): 12.0-15.5 g/dL
No 0
Yes 1
Calcium >10mg/dL (>2.5 mmol/L)
No 0
Yes 1
LDH > 1.5x Upper Limit of Normal
Normal: 140 U/L
No 0
Yes 1
Performance status <80% (Karnofsky)
No 0
Yes 1


Measured Factor
Memorial Sloan-Kettering Cancer Center (MSKCC/Motzer) Score
Measured Factor Disease
  • Metastatic Renal Cell Carcinoma
Measured Factor Detail
Memorial Sloan-Kettering Cancer Center (MSKCC/Motzer) Score predicts prognosis of survival months based on the hemoglobin level, LDH level, serum calcium level, initial diagnosis time for treatment, and Karnofsky performance. Score 0 indicates low risk with 20 months of survival, Score 1-2 indicates intermediate risk with 10 months of survival, and Score > or = 3 indicates high risk with 4 months of survival with metastetic renal cell carcinoma.
Body System
Measured Factor High Impact
  • Decrease in survival rate
Calculating serum lactate dehydrogenase (LDH) level using lactate dehydrogenase (LDH) test to check increase or decrease level of LDH as compare to normal level of LDH | Calculating hemoglobin level by hemoglobin test to check increase or decrease level of LDH as compare to normal hemoglobin level | Calculating serum calcium level by serum calcium test to detect the calcium level as compared to normal calcium level.
  • Pectus excavatum disease can interfere with LDH levels

Result Interpretation

Ranges Ranges
  • Critical High: Score > or = 3
  • Normal: Score 0
  • Normal Adult Male: Score 0
  • Normal Adult Female: Score 0
  • Normal Geriatric Male: Score 0
  • Normal Geriatric Female: Score 0
Result High Conditions
  • Metastatic Renal Cell Carcinoma
False Positive
  • Pectus excavatum disease can interfere with LDH levels
References: 2
Test Limitations
This score can only be applied to patients with metastatic RCC only.
References: 1


Study Validation 1
The aim of the study was to investigate the prognostic factors and a model for predicting overall survival in 670 patients with metastatic renal-cell carcinoma (RCC). Proportional hazards regression was used to calculate the overall survival using Memorial Sloan-Kettering Cancer Center motzer-score . Results showed that patients falling under poor risk group had minimal survival time of 4 months when compared with other 2 groups. The study concluded that this multivariable model was accurately able to predict the five prognostic factors for predicting survival and to classify the patients based on their risk score.
References: 1
Study Additional 1
This randomized, phase III trial was conducted with the aim to compare the performance of sunitinib and interferon alfa (IFN-alpha) as first-line treatment for metastatic renal cell carcinoma (RCC). A total 750 patients with RCC were recruited for the trial. Sunitinib 50 mg orally once daily for 4 weeks was administered to the patients while IFN-alpha was given at dose of 9 MU subcutaneously thrice weekly. Overall survival was compared for both the therapies. This study concluded that overall survival was better in case of sunitinib therapy with 11 months median progression free survival  compared to 5 months for IFN-alpha targeted therapy.
References: 3
Study Additional 2
The aim of this retrospective study was to simple prognostic model which could predict overall survival in patients with metastatic renal cell carcinoma (mRCC). A multivariate Cox proportional hazards regression model was used to calculate the results. 3 risk factors were included in the multivariate model: hemoglobin, prior nephrectomy, and time from diagnosis to treatment. Patients were classified in 3 different risk groups depending on the number of factors they had. Results showed that patients in higher risk groups were having low survival rates compared to the patients in low risk groups. This study concluded that hemoglobin below normal absence of earlier nephrectomy, and starting of treatment within one year of diagnosis were factors affecting the survival rates in patients with (mRCC).
References: 4


  1. Motzer RJ, Mazumdar M, Bacik J, Berg W, Amsterdam A, Ferrara J. Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. J Clin Oncol. 1999;17(8):2530-40.
  2. Kim JJ, Kim CK, Park HJ, et al. Elevation of serum lactate dehydrogenase in patients with pectus excavatum. J Cardiothorac Surg. 2014;9:75.
  3. Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Oudard S, et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009;27(22):3584-90.
  4. Assi HI, Patenaude F, Toumishey E, Ross L, Abdelsalam M, Reiman T. A simple prognostic model for overall survival in metastatic renal cell carcinoma. Can Urol Assoc J. 2016;10(3-4):113-9.

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