Clinical calculator summary
Original 2002 Mayo SSIGN Score
Clinical calculator summary
Original 2002 Mayo SSIGN Score
A postoperative clear-cell RCC score combining original 1997 TNM stage, tumor size, nuclear grade, and coagulative necrosis.
Evidence-based context for fast calculator use
- Purpose:
- Reproduce the original SSIGN score and matched historical cancer-specific-survival row.
- Population:
- Adults with sporadic unilateral clear-cell RCC treated by radical nephrectomy.
- Factors:
- 1997 pathologic T, N, and M categories, Maximum tumor size, Nuclear grade, Coagulative necrosis
- Reference:
- Frank I, et al. J Urol. 2002;168(6):2395-2400.
SSIGN Score (Mayo)
Clinical Context & Background
Original 2002 Mayo SSIGN score = 1997 pathologic T-stage points + nodal points + metastasis points + 2 points for tumor size >=5 cm + nuclear-grade points + 2 points for coagulative necrosis.Reference Data
| Original SSIGN score | Historical 5-year cancer-specific survival |
|---|---|
| 0-1 | 99.4% |
| 2 | 94.8% |
| 3 | 87.8% |
| 4 | 79.1% |
| 5 | 65.4% |
| 6 | 54.0% |
| 7 | 41.0% |
| 8 | 23.6% |
| 9 | 19.6% |
| >=10 | 7.4% |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use after radical nephrectomy when clear-cell histology and complete 1997-TNM pathologic information are available.
- Enter the maximum tumor size without rounding and pathology-confirmed grade and coagulative necrosis.
How To Interpret
- Add the six original source contributions and match the raw total to its original 5-year cancer-specific-survival row.
- Treat the survival figure as a historical cohort observation rather than a patient-specific probability.
What To Do Next
- Integrate pathology, contemporary staging, comorbidity, imaging, molecular information, and multidisciplinary assessment.
- Use current guidelines and validated contemporary tools for treatment and surveillance decisions.
Limitations
- Original model used 1997 TNM and must not be silently mixed with later staging editions.
- Not validated as the original model for non-clear-cell, bilateral, hereditary, or biopsy-only disease.
- Original tumor-size range was approximately 0.8-24 cm; values outside it require cautious interpretation.
- Not a treatment-selection or individualized survival tool.
Validated Population
Sporadic unilateral clear-cell RCC after radical nephrectomy in the historical Mayo cohort.
Exact 5 cm boundary
A tumor measuring exactly 5 cm receives two size points in the original model.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed cases passed through visible production controls at SSIGN scores 0, 2, and 15.
- The raw 5 cm tumor-size transition rendered as expected.
- No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/ssign-rcc-2026-08-03.json.
: 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-console. 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/ssign-rcc.json.
: Browser input adapter corrected and reverified
- Accepted finite number values already normalized by the shared calculator form while retaining strict malformed-input rejection.
- No equation, cutoff, unit, classification, or applicability rule changed; calculator-specific verification and the calculator-wide browser-input audit passed.
: Full validation test
- 768/768 source-rule, boundary, invalid-input, trace, scope, UI/integration, immutability, registry, and no-panel-inheritance checks passed, including 512 exhaustive score/outcome assertions.
- No registered master panel calculates SSIGN; no panel receives inherited verification.
: Calculation and input-contract correction
- Restored the original 1997-TNM weights, including pT4 = 0, coagulative necrosis = 2, and tumor size >=5 cm = 2, and replaced grouped outcomes with the ten original score-specific CSS rows.
- Replaced favorable pre-scored defaults and arbitrary summation with exact semantic categories, raw finite positive size, strict exact-key validation, a reconciled trace, source-range warnings, and historical non-individualized outcome wording.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Related Tools
Frequently Asked Questions
Why does pT4 receive zero points?
That unusual weight is the value in the original 2002 SSIGN table and is preserved rather than altered by inference.
Does a tumor exactly 5 cm receive size points?
Yes. Tumor size at or above 5 cm receives two points using the unrounded measurement.
Can this use a modern TNM stage directly?
Not automatically. The model was derived with 1997 TNM, so any mapping from a later edition must be deliberate and clinically reviewed.
Evidence-based oncology decision support. Verify with clinical guidelines.