MSKCC Motzer score (1999)

Motzer

Sum the Motzer 1999 MSKCC adverse factors for advanced RCC and return favorable (0), intermediate (1–2), or poor (≥3). Motzer 1999 reported median survival of 20, 10, and 4 months in those interferon-era groups as published cohort results, not a predicted survival.

LIVE $0.005 USDC GET /api/calc/motzer

Markdown: /docs/motzer.md · Canonical: https://magentlab.com/docs/motzer

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

When to use

When an agent needs the published Motzer 1999 MSKCC point total and risk group and must not invent an RCC diagnosis or treatment recommendation, must not use IMDC or Motzer 2002/2004, and must not assign KPS or assay labs.

When not to use

Not a medical device and not an RCC diagnosis or treatment recommendation. magent does not examine the patient.
Not IMDC (Heng 2009). This tool does not include neutrophils or platelets.
Not Motzer 2002 or Motzer 2004. The fifth factor is absence of prior nephrectomy, not time from diagnosis to treatment.
magent does not assay LDH, hemoglobin, or calcium, apply ULN/LLN, or observe Karnofsky performance status. All five inputs are caller-assigned flags.
Motzer 1999 overall-survival figures are published interferon-era cohort results, not a predicted survival or a treatment choice.

Formula

Motzer = kps_lt_80 1 + ldh_gt_1_5_uln 1 + hemoglobin_lt_lln 1 + corrected_calcium_gt_10 1 + no_prior_nephrectomy 1; Motzer 1999; max 5; favorable 0, intermediate 1-2, poor ≥3

Citation

Title: Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma
Authors: Motzer RJ, Mazumdar M, Bacik J, Berg W, Amsterdam A, Ferrara J.
Source: J Clin Oncol. 1999;17(8):2530-2540
DOI: 10.1200/JCO.1999.17.8.2530

Worked example

All flags false

Given: corrected_calcium_gt_10=falsehemoglobin_lt_lln=falsekps_lt_80=falseldh_gt_1_5_uln=falseno_prior_nephrectomy=false

All five caller-assigned flags false → 0
Score = 0 (max 5); motzer_band = favorable

KPS <80, LDH >1.5×ULN, and hemoglobin <LLN

Given: corrected_calcium_gt_10=falsehemoglobin_lt_lln=truekps_lt_80=trueldh_gt_1_5_uln=trueno_prior_nephrectomy=false

kps_lt_80 → 1; ldh_gt_1_5_uln → 1; hemoglobin_lt_lln → 1; remaining flags 0
Score = 3 (max 5); motzer_band = poor (≥3)

Also searched as

Motzer score
MSKCC criteria
MSKCC Motzer
metastatic RCC Motzer
Motzer 1999
renal cell carcinoma risk
MSKCC RCC
Karnofsky Motzer

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/motzer?kps_lt_80=false&ldh_gt_1_5_uln=false&hemoglobin_lt_lln=false&corrected_calcium_gt_10=false&no_prior_nephrectomy=false

Full URL: https://api.magentlab.com/api/calc/motzer?kps_lt_80=false&ldh_gt_1_5_uln=false&hemoglobin_lt_lln=false&corrected_calcium_gt_10=false&no_prior_nephrectomy=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/motzer?kps_lt_80=false&ldh_gt_1_5_uln=false&hemoglobin_lt_lln=false&corrected_calcium_gt_10=false&no_prior_nephrectomy=false"

Parameters

Name	Type	Required	Description
`kps_lt_80`	boolean	required	Karnofsky performance status <80% as assigned by the caller (Motzer 1999). true scores 1. magent does not observe KPS.
`ldh_gt_1_5_uln`	boolean	required	Serum LDH >1.5 × institutional ULN as assigned by the caller (Motzer 1999). true scores 1. magent does not assay LDH or apply ULN.
`hemoglobin_lt_lln`	boolean	required	Hemoglobin below the institutional lower limit of normal as assigned by the caller (Motzer 1999). true scores 1. magent does not assay hemoglobin or apply LLN.
`corrected_calcium_gt_10`	boolean	required	Corrected calcium >10 mg/dL as assigned by the caller (Motzer 1999 paper threshold, not institutional ULN). true scores 1. magent does not assay calcium.
`no_prior_nephrectomy`	boolean	required	Absence of prior nephrectomy as assigned by the caller (Motzer 1999). true scores 1. Not Motzer 2004 time from diagnosis to treatment. magent does not review operative history.

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.

POST /api/calc/motzer Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 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 (fixture)

{
  "items": [
    {
      "corrected_calcium_gt_10": "false",
      "hemoglobin_lt_lln": "false",
      "kps_lt_80": "false",
      "ldh_gt_1_5_uln": "false",
      "no_prior_nephrectomy": "false"
    },
    {
      "corrected_calcium_gt_10": "false",
      "hemoglobin_lt_lln": "false",
      "kps_lt_80": "false",
      "ldh_gt_1_5_uln": "false",
      "no_prior_nephrectomy": "false"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/motzer",
  "items": [
    {
      "components": [
        {
          "factor": "kps_lt_80",
          "points": 0,
          "present": false
        },
        {
          "factor": "ldh_gt_1_5_uln",
          "points": 0,
          "present": false
        },
        {
          "factor": "hemoglobin_lt_lln",
          "points": 0,
          "present": false
        },
        {
          "factor": "corrected_calcium_gt_10",
          "points": 0,
          "present": false
        },
        {
          "factor": "no_prior_nephrectomy",
          "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": "Motzer RJ, Mazumdar M, Bacik J, Berg W, Amsterdam A, Ferrara J.",
        "doi": "10.1200/JCO.1999.17.8.2530",
        "id": "motzer-1999",
        "pmid": "10561319",
        "source": "J Clin Oncol. 1999;17(8):2530-2540",
        "title": "Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma"
      },
      "formula": "motzer",
      "formula_expression": "Motzer = kps_lt_80 1 + ldh_gt_1_5_uln 1 + hemoglobin_lt_lln 1 + corrected_calcium_gt_10 1 + no_prior_nephrectomy 1; Motzer 1999; max 5; favorable 0, intermediate 1-2, poor ≥3",
      "max_score": 5,
      "score": 0,
      "motzer_band": "favorable"
    },
    {
      "components": [
        {
          "factor": "kps_lt_80",
          "points": 0,
          "present": false
        },
        {
          "factor": "ldh_gt_1_5_uln",
          "points": 0,
          "present": false
        },
        {
          "factor": "hemoglobin_lt_lln",
          "points": 0,
          "present": false
        },
        {
          "factor": "corrected_calcium_gt_10",
          "points": 0,
          "present": false
        },
        {
          "factor": "no_prior_nephrectomy",
          "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": "Motzer RJ, Mazumdar M, Bacik J, Berg W, Amsterdam A, Ferrara J.",
        "doi": "10.1200/JCO.1999.17.8.2530",
        "id": "motzer-1999",
        "pmid": "10561319",
        "source": "J Clin Oncol. 1999;17(8):2530-2540",
        "title": "Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma"
      },
      "formula": "motzer",
      "formula_expression": "Motzer = kps_lt_80 1 + ldh_gt_1_5_uln 1 + hemoglobin_lt_lln 1 + corrected_calcium_gt_10 1 + no_prior_nephrectomy 1; Motzer 1999; max 5; favorable 0, intermediate 1-2, poor ≥3",
      "max_score": 5,
      "score": 0,
      "motzer_band": "favorable"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	motzer
`formula_expression`	string	Exact expression used
`score`	integer	Motzer 1999 points 0-5
`max_score`	integer	Always 5
`motzer_band`	string	favorable when score is 0, intermediate when 1–2, poor when 3–5 (Motzer 1999 MSKCC). Not an RCC diagnosis or treatment recommendation. Not IMDC. Not Motzer 2002/2004. Caller assigns KPS, LDH vs 1.5×ULN, hemoglobin vs LLN, corrected calcium vs 10 mg/dL, and prior nephrectomy.
`components`	array	Per-factor points
`citation`	object	Motzer 1999 J Clin Oncol citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "factor": "kps_lt_80",
      "points": 0,
      "present": false
    },
    {
      "factor": "ldh_gt_1_5_uln",
      "points": 0,
      "present": false
    },
    {
      "factor": "hemoglobin_lt_lln",
      "points": 0,
      "present": false
    },
    {
      "factor": "corrected_calcium_gt_10",
      "points": 0,
      "present": false
    },
    {
      "factor": "no_prior_nephrectomy",
      "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": "Motzer RJ, Mazumdar M, Bacik J, Berg W, Amsterdam A, Ferrara J.",
    "doi": "10.1200/JCO.1999.17.8.2530",
    "id": "motzer-1999",
    "pmid": "10561319",
    "source": "J Clin Oncol. 1999;17(8):2530-2540",
    "title": "Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma"
  },
  "formula": "motzer",
  "formula_expression": "Motzer = kps_lt_80 1 + ldh_gt_1_5_uln 1 + hemoglobin_lt_lln 1 + corrected_calcium_gt_10 1 + no_prior_nephrectomy 1; Motzer 1999; max 5; favorable 0, intermediate 1-2, poor ≥3",
  "max_score": 5,
  "score": 0,
  "motzer_band": "favorable"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_flag`	boolean clinical flags must be true or false Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

IMDC — Sum the Heng 2009 IMDC adverse factors for metastatic RCC treated with VEGF-targeted agents and return favorable (0), intermediate (1–2), or poor (3–6). Heng 2009 reported 2-year OS 75% (median not reached), 53% (median 27 months), and 7% (median 8.8 months) in those groups.

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. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /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.
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.