# Leibovich 2018 histology-specific RCC models Leibovich 2018 RCC models Status: LIVE Price: $0.005 USDC `GET /api/calc/leibovich_2018` HTML: https://magentlab.com/docs/leibovich-2018 Markdown: https://magentlab.com/docs/leibovich-2018.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the Leibovich 2018 progression-free score from caller-assigned histology, 2010 T and N, tumor size, nuclear grade, and necrosis, and return the published risk grouping for that histology. ## When to use When an agent already has surgical histology (clear cell, papillary, or chromophobe), 2010 pathologic T and N, size in cm, nuclear grade, and necrosis and needs the 2018 PFS total and low/intermediate/high group. magent does not stage the tumor or read slides, and must not invent an RCC diagnosis, SSIGN, or the 2003 Leibovich Cancer table. ## When not to use - Not a medical device. magent does not stage the tumor or read pathology. - Leibovich 2018 histology-specific models only. Not Frank 2002 SSIGN (1997 TNM, size 5 cm, pT4 0). Not the 2003 Leibovich Cancer table (2002 TNM, T1b 2, T2 3, T3-4 4, necrosis 1, N1/N2). - ccRCC uses 2010 TNM tokens and additive PFS points. The 2018 paper also published a nine-factor ccRCC PFS conversion (symptoms, sarcomatoid, fat, thrombus, extension) and a separate CSS score; those extra factors are not inputs here. - Papillary groups use grade plus T as a fat/thrombus proxy. Chromophobe groups use T as a fat proxy plus N; sarcomatoid is not an input. Chromophobe has no CSS model in the paper. - Size uses unrounded cm; 10.0 cm scores 1 on ccRCC. Magent clamp 0.1-30 cm is not a published range. - Published groups are cohort strata, not an individualized prediction or a treatment recommendation. Not an RCC diagnosis. ## Formula ``` ccRCC PFS (Leibovich 2018, 2010 TNM): t_stage (t1a/t1b/t2a 0, t2b 2, t3a/t3b/t3c 3, t4 4) + n_stage (nx/n0 0, n1 2) + tumor_size_cm >=10 1 + nuclear_grade (1-2 0, 3 1, 4 3) + necrosis 2; max 12; risk low 0-2, intermediate 3-5, high >=6. papillary PFS groups: low grade 1-2 and t1-t2; intermediate grade 3 and t1-t2; high grade 4 or t3a-t4 (fat or thrombus). chromophobe PFS groups: low t1-t2 and nx/n0; intermediate t3a-t4 and nx/n0 (fat); high n1. Not Frank 2002 SSIGN. Not Leibovich 2003. No chromophobe CSS model. ``` ## Citation [Predicting Oncologic Outcomes in Renal Cell Carcinoma After Surgery](https://doi.org/10.1016/j.eururo.2018.01.005) Leibovich BC, Lohse CM, Cheville JC, Zaid HB, Boorjian SA, Frank I, Thompson RH, Parker WP Eur Urol. 2018;73(5):772-780 DOI: [10.1016/j.eururo.2018.01.005](https://doi.org/10.1016/j.eururo.2018.01.005) ## Worked example ### Lowest-risk ccRCC pT1a N0 size <10 cm grade 2 no necrosis Given: `histology=clear_cell, n_stage=n0, necrosis=false, nuclear_grade=2, t_stage=t1a, tumor_size_cm=3` 1. clear_cell; t1a → 0; n0 → 0 2. size 3 cm <10 → 0; nuclear_grade 2 → 0; necrosis false → 0 3. Score = 0 (max 12); risk = low ### Highest-weight ccRCC pT4 N1 size ≥10 cm grade 4 necrosis Given: `histology=clear_cell, n_stage=n1, necrosis=true, nuclear_grade=4, t_stage=t4, tumor_size_cm=12` 1. clear_cell; t4 → 4; n1 → 2; size 12 cm ≥10 → 1; nuclear_grade 4 → 3; necrosis true → 2 2. Score = 12 (max 12); risk = high ## Also searched as - Leibovich 2018 - 2018 Leibovich model - ccRCC progression score - papillary RCC risk group - chromophobe RCC risk group - histology-specific RCC score - 2010 TNM RCC score - Leibovich PFS groups ## Parameters - `histology` (string, required): Surgical histology as assigned by the caller (Leibovich 2018). clear_cell, papillary, or chromophobe. Not collecting-duct or unclassified. magent does not read slides. - `t_stage` (string, required): 2010 pathologic T as assigned by the caller (Leibovich 2018). t1a, t1b, t2a, t2b, t3a, t3b, t3c, or t4. Not 1997/2002 T without a/b substages. magent does not stage the tumor. - `n_stage` (string, required): 2010 pathologic N as assigned by the caller (Leibovich 2018). nx or n0 scores 0 on ccRCC; n1 scores 2. Not n2 (2002 N). magent does not stage nodes. - `tumor_size_cm` (number, required): Maximum tumor size in cm as assigned by the caller (Leibovich 2018). Unrounded; 10.0 cm or greater scores 1 on ccRCC. Magent clamp 0.1-30, not a published range. magent does not measure the tumor. - `nuclear_grade` (integer, required): Nuclear grade 1-4 as assigned by the caller (Leibovich 2018). On ccRCC, 1-2 score 0; 3 scores 1; 4 scores 3. Integer 1-4 only; reject 0, 5, 1.5, and roman I. magent does not read slides. - `necrosis` (boolean, required): Histologic tumor necrosis as assigned by the caller (Leibovich 2018). true scores 2 on ccRCC. magent does not read slides. ## Bulk (POST) POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/leibovich_2018` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "histology": "clear_cell", "n_stage": "n0", "necrosis": "false", "nuclear_grade": "2", "t_stage": "t1a", "tumor_size_cm": "3" }, { "histology": "clear_cell", "n_stage": "n0", "necrosis": "false", "nuclear_grade": "2", "t_stage": "t1a", "tumor_size_cm": "3" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/leibovich-2018 Example 200: ```json { "count": 2, "path": "/api/calc/leibovich_2018", "items": [ { "components": [ { "value": "t1a", "factor": "t_stage", "points": 0, "present": true }, { "value": "n0", "factor": "n_stage", "points": 0, "present": true }, { "value": 3.0, "factor": "tumor_size_cm", "points": 0, "present": false }, { "value": 2, "factor": "nuclear_grade", "points": 0, "present": true }, { "factor": "necrosis", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Leibovich BC, Lohse CM, Cheville JC, Zaid HB, Boorjian SA, Frank I, Thompson RH, Parker WP", "doi": "10.1016/j.eururo.2018.01.005", "id": "leibovich-2018", "pmid": "29398265", "source": "Eur Urol. 2018;73(5):772-780", "title": "Predicting Oncologic Outcomes in Renal Cell Carcinoma After Surgery" }, "formula": "leibovich_2018", "formula_expression": "ccRCC PFS (Leibovich 2018, 2010 TNM): t_stage (t1a/t1b/t2a 0, t2b 2, t3a/t3b/t3c 3, t4 4) + n_stage (nx/n0 0, n1 2) + tumor_size_cm >=10 1 + nuclear_grade (1-2 0, 3 1, 4 3) + necrosis 2; max 12; risk low 0-2, intermediate 3-5, high >=6. papillary PFS groups: low grade 1-2 and t1-t2; intermediate grade 3 and t1-t2; high grade 4 or t3a-t4 (fat or thrombus). chromophobe PFS groups: low t1-t2 and nx/n0; intermediate t3a-t4 and nx/n0 (fat); high n1. Not Frank 2002 SSIGN. Not Leibovich 2003. No chromophobe CSS model.", "max_score": 12, "score": 0, "risk": "low", "t_stage": "t1a", "histology": "clear_cell", "n_stage": "n0", "necrosis": false, "nuclear_grade": 2, "tumor_size_cm": 3.0 }, { "components": [ { "value": "t1a", "factor": "t_stage", "points": 0, "present": true }, { "value": "n0", "factor": "n_stage", "points": 0, "present": true }, { "value": 3.0, "factor": "tumor_size_cm", "points": 0, "present": false }, { "value": 2, "factor": "nuclear_grade", "points": 0, "present": true }, { "factor": "necrosis", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Leibovich BC, Lohse CM, Cheville JC, Zaid HB, Boorjian SA, Frank I, Thompson RH, Parker WP", "doi": "10.1016/j.eururo.2018.01.005", "id": "leibovich-2018", "pmid": "29398265", "source": "Eur Urol. 2018;73(5):772-780", "title": "Predicting Oncologic Outcomes in Renal Cell Carcinoma After Surgery" }, "formula": "leibovich_2018", "formula_expression": "ccRCC PFS (Leibovich 2018, 2010 TNM): t_stage (t1a/t1b/t2a 0, t2b 2, t3a/t3b/t3c 3, t4 4) + n_stage (nx/n0 0, n1 2) + tumor_size_cm >=10 1 + nuclear_grade (1-2 0, 3 1, 4 3) + necrosis 2; max 12; risk low 0-2, intermediate 3-5, high >=6. papillary PFS groups: low grade 1-2 and t1-t2; intermediate grade 3 and t1-t2; high grade 4 or t3a-t4 (fat or thrombus). chromophobe PFS groups: low t1-t2 and nx/n0; intermediate t3a-t4 and nx/n0 (fat); high n1. Not Frank 2002 SSIGN. Not Leibovich 2003. No chromophobe CSS model.", "max_score": 12, "score": 0, "risk": "low", "t_stage": "t1a", "histology": "clear_cell", "n_stage": "n0", "necrosis": false, "nuclear_grade": 2, "tumor_size_cm": 3.0 } ] } ``` ## Response fields - `formula` (string): leibovich_2018 - `formula_expression` (string): Exact expression used - `histology` (string): Caller-assigned histology used (clear_cell, papillary, or chromophobe) - `t_stage` (string): Caller-assigned 2010 T used (t1a, t1b, t2a, t2b, t3a, t3b, t3c, or t4) - `n_stage` (string): Caller-assigned 2010 N used (nx, n0, or n1) - `tumor_size_cm` (number): Caller-assigned tumor size in cm used (unrounded at the 10 cm boundary) - `nuclear_grade` (integer): Caller-assigned nuclear grade 1-4 used - `necrosis` (boolean): Caller-assigned histologic necrosis flag used - `score` (integer): Leibovich 2018 PFS integer: ccRCC 0-12 additive points; papillary and chromophobe 0-2 group index. Not an RCC diagnosis. - `max_score` (integer): 12 for clear_cell; 2 for papillary and chromophobe - `risk` (string): low, intermediate, or high. ccRCC uses 0-2 / 3-5 / >=6 on the 2018 weights. papillary and chromophobe use the 2018 three groups. Historical grouping, not an individualized prediction. - `components` (array): Per-factor Leibovich 2018 PFS points - `citation` (object): Leibovich et al. Eur Urol 2018 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": "t1a", "factor": "t_stage", "points": 0, "present": true }, { "value": "n0", "factor": "n_stage", "points": 0, "present": true }, { "value": 3.0, "factor": "tumor_size_cm", "points": 0, "present": false }, { "value": 2, "factor": "nuclear_grade", "points": 0, "present": true }, { "factor": "necrosis", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Leibovich BC, Lohse CM, Cheville JC, Zaid HB, Boorjian SA, Frank I, Thompson RH, Parker WP", "doi": "10.1016/j.eururo.2018.01.005", "id": "leibovich-2018", "pmid": "29398265", "source": "Eur Urol. 2018;73(5):772-780", "title": "Predicting Oncologic Outcomes in Renal Cell Carcinoma After Surgery" }, "formula": "leibovich_2018", "formula_expression": "ccRCC PFS (Leibovich 2018, 2010 TNM): t_stage (t1a/t1b/t2a 0, t2b 2, t3a/t3b/t3c 3, t4 4) + n_stage (nx/n0 0, n1 2) + tumor_size_cm >=10 1 + nuclear_grade (1-2 0, 3 1, 4 3) + necrosis 2; max 12; risk low 0-2, intermediate 3-5, high >=6. papillary PFS groups: low grade 1-2 and t1-t2; intermediate grade 3 and t1-t2; high grade 4 or t3a-t4 (fat or thrombus). chromophobe PFS groups: low t1-t2 and nx/n0; intermediate t3a-t4 and nx/n0 (fat); high n1. Not Frank 2002 SSIGN. Not Leibovich 2003. No chromophobe CSS model.", "max_score": 12, "score": 0, "risk": "low", "t_stage": "t1a", "histology": "clear_cell", "n_stage": "n0", "necrosis": false, "nuclear_grade": 2, "tumor_size_cm": 3.0 } ``` ## Errors - HTTP 400 `invalid_rcc_histology`: histology must be clear_cell, papillary, or chromophobe (Leibovich 2018). Returned before settlement; you are not charged. - HTTP 400 `invalid_t_stage`: t_stage must be a pathologic T token from the cited paper (Leibovich 2018). Returned before settlement; you are not charged. - HTTP 400 `invalid_n_stage`: n_stage must be nx, n0, or n1 (Leibovich 2018). Returned before settlement; you are not charged. - HTTP 400 `invalid_nuclear_grade`: nuclear_grade must be an integer from 1 to 4 (Leibovich 2018). Returned before settlement; you are not charged. - HTTP 400 `invalid_tumor_size_cm`: tumor_size_cm must be a number from 0.1 to 30 (Leibovich 2018 tumor size cm). Returned before settlement; you are not charged. - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [SSIGN score](https://magentlab.com/docs/ssign) — Sum the Frank 2002 SSIGN score from caller-assigned 1997 TNM, tumor size, nuclear grade, and coagulative necrosis, and return the published cancer-specific survival row. - [Fuhrman](https://magentlab.com/docs/fuhrman) — Echo the caller-assigned Fuhrman 1982 nuclear grade (1-4) with the published nuclear-feature description. magent does not read slides. Not WHO/ISUP 2016. ## Payment Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON. - exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.