Saved Results

No results saved yet.

Enter a patient name and hit Save on a result.

Clinical calculator summary

Original 2009 IMDC (Heng) prognostic model

A six-factor additive prognostic classification for metastatic renal cell carcinoma.

Evidence-based context for fast calculator use

Purpose:
Assign the original favorable, intermediate, or poor IMDC prognostic group.
Population:
Patients with metastatic renal cell carcinoma assessed before systemic therapy; displayed survival medians are from a 2013 first-line VEGF-targeted cohort.
Factors:
KPS <80%, Diagnosis-to-treatment interval <1 year, Hemoglobin < institutional LLN, Corrected calcium > institutional ULN, ANC > institutional ULN, Platelets > institutional ULN
Reference:
Heng et al., JCO 2009; external-validation outcomes from Heng et al., Lancet Oncology 2013.
HomeIMDC (Heng) Risk Criteria Calculator — Metastatic Renal Cell Carcinoma
Pin your most used calculators here by clicking the star in the dropdown.

IMDC (Heng) Risk Criteria Calculator — Metastatic Renal Cell Carcinoma

Clinical Context & Background

This calculator implements the original 2009 International Metastatic Renal Cell Carcinoma Database Consortium (IMDC/Heng) additive prognostic model for metastatic renal cell carcinoma before systemic therapy.
One adverse point is assigned for each of six findings: KPS below 80%, less than one year from diagnosis to systemic treatment, hemoglobin below the institutional lower limit of normal, corrected calcium above the institutional upper limit of normal, absolute neutrophil count above the institutional upper limit of normal, and platelet count above the institutional upper limit of normal. Values exactly at KPS 80%, one year, the hemoglobin LLN, or a laboratory ULN are non-adverse.
The displayed 43.2, 22.5, and 7.8 month median overall-survival values come from a separate 2013 external-validation cohort receiving first-line VEGF-targeted therapy. They are historical group-level cohort estimates, not modern individualized survival predictions or a treatment-selection rule.
Primary Source EvidenceHeng DYC, et al. J Clin Oncol. 2009;27:5794-5799. doi:10.1200/JCO.2008.21.4809. Heng DYC, et al. Lancet Oncol. 2013;14:141-148.
Formula Logic
IMDC score = number of adverse factors present (1 point each; total 0-6)

Reference Data

Risk GroupNumber of Risk Factors2013 External-Validation Median OS
Favorable Risk043.2 months (95% CI 31.4-50.1)
Intermediate Risk1-222.5 months (95% CI 18.7-25.1)
Poor Risk3-67.8 months (95% CI 6.5-9.7)

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use for pretreatment prognostic stratification in metastatic renal cell carcinoma when all six baseline criteria are known.
  • Compare laboratory values with the matching institutional reference interval; do not substitute generic fixed cutoffs.

How To Interpret

  • Zero adverse factors is favorable, one or two is intermediate, and three to six is poor risk.
  • The displayed median overall-survival values describe a historical 2013 first-line VEGF-targeted cohort and are not individualized forecasts.

What To Do Next

  • Document the six baseline findings, institutional LLN/ULN values used, total score, and risk group.
  • Use current disease-specific guidance and individualized assessment for treatment decisions rather than the score alone.

Limitations

  • Not validated as a standalone treatment-selection rule, for localized disease, or as a postoperative recurrence model.
  • The derivation included any RCC histology but was dominated by clear-cell disease and VEGF-targeted treatment-era data.
  • The original source does not mandate one albumin-correction equation for corrected calcium.

Validated Population

Metastatic RCC assessed at baseline before VEGF-targeted systemic therapy; historical outcomes shown are from first-line VEGF-targeted external validation.

Group assignment

Two adverse factors produce an IMDC score of 2 and the Intermediate Risk group.

Renal cancer calculatorsReview related renal tools without treating their outputs as interchangeable.

Calculation verification history

Verified

  1. : Production browser revalidation

    • Three source-backed cases passed through visible production controls at IMDC scores 0, 2, and 6.
    • Favorable, Intermediate, and Poor groups rendered without the former generic risk gauge.
    • No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
    Download latest production check (Excel)

    Case-level evidence is retained in validation/browser-revalidation/imdc-renal-cell-carcinoma-risk-2026-08-03.json.

  2. : Local browser remediation

    • Valid IMDC results now explicitly suppress the shared generic risk gauge so Favorable, Intermediate, and Poor source terminology is not relabeled.
    • Ten source-backed cases passed through visible local browser controls across 11 submissions, covering scores 0-6, every factor, all three groups, required-field validation, and reset/repeat behavior.
    • The existing calculator-specific audit passed 683/683. Production status remains open until this commit is deployed and the public route is revalidated.

    Local case-level remediation evidence is retained in validation/browser-production/imdc-renal-cell-carcinoma-risk.local-remediation.json.

  3. : Production browser validation

    • Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
    • Overall browser status: failed-ui-console. medium: Every valid result adds a generic Low Risk / Intermediate / High Risk gauge instead of the source-defined Favorable / Intermediate / Poor group terminology. | medium: Production emitted minified React error #418 during route loads and interactions.
    • Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.

    Case-level production evidence is retained in validation/browser-production/imdc-renal-cell-carcinoma-risk.json.

  4. : Full validation test

    • Verified all 64 factor combinations, source-threshold semantics, strict invalid-input handling, matched rows, six-factor trace, standalone behavior, and 128 renal-panel IMDC parity projections with LDH excluded.

  5. : Correction history

    • Removed favorable defaults and coercive values, required all six exact criteria, added a complete trace and matched row, correctly attributed survival medians to the 2013 VEGF-targeted external-validation cohort, removed treatment-selection claims, and connected the renal panel to the shared IMDC engine.

Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.

Found a possible issue? Report it to improve this calculator

Share This Calculator

Share:

Related Tools

MSKCC (Motzer) ScoreLeibovich Score (RCC)SSIGN Score (Mayo)

Frequently Asked Questions

Are values equal to a threshold adverse?

No. KPS 80%, exactly one year, hemoglobin at the LLN, and calcium, neutrophils, or platelets at the ULN are non-adverse.

Should fixed laboratory cutoffs be used?

No. The original model compares results with the applicable institutional LLN or ULN.

Do the survival medians predict an individual patient’s current outcome?

No. They are historical group medians from a 2013 first-line VEGF-targeted external-validation cohort.

Evidence-based oncology decision support. Verify with clinical guidelines.