Pathological nodal staging score for renal cell carcinoma: how to build reliable therapeutic choices basing on assumptions

In the interesting article originally published in the World Journal of Urology at the end of 2018, Malte Rieken and eminent coauthors, from both American and European countries, proposed and externally validated a pathological nodal staging score (pNSS) for patients with clear cell renal cell carcinoma (ccRCC) (1). They developed such β-binomial model to estimate the probability that a ccRCC patient with pathologic node-negative status at radical nephrectomy (RN) and lymph node dissection (LND) truly has no lymph node metastases (LNM), with the aim to refine patient counseling, to improve decision-making about surveillance regimens and to possibly identify inclusion criteria for trials of adjuvant therapy.