Rarity limits the breadth of study on clear cell sarcoma of the kidney (CCSK). There is currently no predictive model that quantifies the overall survival (OS) of CCSK and a few large sample-based analysis of relapse-related factors.

Patients were collected both from the Surveillance, Epidemiology, and End Results (SEER) database and case report articles extracted from the global online document database to form 2 groups. The first was the OS group, which was used to build and verify the nomogram for predicting the OS of CCSK. Independent predictors of OS were screened by Cox regression analysis to develop the nomogram. Nomogram accuracy was assessed by C-index, receiver operating characteristic (ROC), calibration, and decision curve analysis (DCA) curves. In addition, the difference in OS between receiving radiotherapy or not in stage I patients was analyzed by the Chi-square test. The second was the relapse group, which was used to analyze the relapse-related factors by Cox regression analysis and the Kaplan–Meier method with the log-rank test.

256 patients were included in the OS group. The stage, chemotherapy, and radiotherapy were independent OS-related factors of CCSK, and the nomogram for predicting the OS of CCSK was established based on them. The results of the C-index, ROC, calibration, and DCA curves showed that the nomogram has good discrimination, accuracy, and clinical profitability. The Chi-squared test showed no significant difference in OS with receiving radiotherapy or not in stage I patients. The relapse group included 153 patients, of which 60 relapsed. The univariate Cox regression analysis showed no correlation between radiotherapy and relapse. The multivariate Cox regression analysis showed that stage and surgery/chemotherapy sequence were the independent factors for relapse. The log-rank test of seven chemotherapeutic drugs showed that etoposide (E), cyclophosphamide (C), vincristine (V), and doxorubicin (D) (all P < 0.05) had significant differences in preventing relapse, and then drew the relapse-free survival curves of these four drugs.

Our nomogram accurately quantified the OS of CCSK. There was no significant difference in OS between receiving radiotherapy or not in stage I patients. Stage, surgery/chemotherapy sequence, and the use of ECVD were relapse-related factors. Radiotherapy had no significant contribution to preventing relapse.

肾脏透明细胞肉瘤（CCSK）的稀有性限制了研究的广度。目前还没有量化 CCSK 总生存期 (OS) 的预测模型，也没有一些基于大样本的复发相关因素分析。

从监测、流行病学和最终结果 (SEER) 数据库中收集患者，并从全球在线文档数据库中提取病例报告文章，将患者分为两组。第一个是 OS 组，用于构建和验证用于预测 CCSK OS 的列线图。通过 Cox 回归分析筛选 OS 的独立预测因子以绘制列线图。列线图的准确性通过 C 指数、受试者工作特征 (ROC)、校准和决策曲线分析 (DCA) 曲线进行评估。此外，通过卡方检验分析I期患者接受放疗与未接受放疗的OS差异。第二个是复发组，通过Cox回归分析和Kaplan-Meier方法结合log-rank检验来分析复发相关因素。

OS 组包括 256 名患者。分期、化疗和放疗是CCSK的独立OS相关因素，并在此基础上建立了预测CCSK OS的列线图。C指数、ROC、校准和DCA曲线的结果表明，列线图具有良好的区分度、准确性和临床盈利能力。卡方检验显示，I 期患者接受或未接受放疗的 OS 没有显着差异。复发组包括153名患者，其中60名复发。单变量 Cox 回归分析显示放疗与复发之间没有相关性。多因素Cox回归分析显示分期和手术/化疗顺序是复发的独立因素。七种化疗药物的时序检验显示，依托泊苷（E）、环磷酰胺（C）、长春新碱（V）和阿霉素（D）（全部磷< 0.05）在预防复发方面存在显着差异，然后绘制了这四种药物的无复发生存曲线。

我们的列线图准确地量化了 CCSK 的操作系统。I 期患者接受与不接受放疗的 OS 没有显着差异。分期、手术/化疗顺序和 ECVD 的使用是复发相关因素。放射治疗对预防复发没有显着贡献。