# UISS for localized RCC (Zisman 2002) UISS Status: LIVE Price: $0.005 USDC `GET /api/calc/uiss` HTML: https://magentlab.com/docs/uiss Markdown: https://magentlab.com/docs/uiss.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Apply the Zisman 2002 localized N0M0 three-group UISS algorithm to caller-assigned 1997 pathological T, Fuhrman grade, and ECOG PS and return low_risk, intermediate_risk, or high_risk. Does not compute a predicted 5-year disease-specific survival. ## When to use When an agent already has surgically resected unilateral RCC that is N0M0, a 1997 pathological T, a Fuhrman 1982 grade, and an ECOG 0-4, and needs the published Zisman 2002 three-group box. magent does not assign TNM, read slides, or observe performance status. Not 2001 UISS I-V, not metastatic UISS, and not SSIGN. ## When not to use - Not a medical device and not a diagnosis of renal cell carcinoma. magent does not assign TNM or read slides. - Zisman 2002 localized N0M0 three-group algorithm only (as reproduced in EAU/ESMO decision boxes of that paper). Not the 2001 five-group UISS I-V. Not metastatic UISS. N-positive or M-positive disease is out of scope. - Not SSIGN. This tool does not implement the Mayo SSIGN score. - t_stage is caller-assigned 1997 pathological T (t1-t4). fuhrman_grade and ecog are caller-assigned. magent does not grade nuclei or observe the patient. - Requires surgically resected unilateral RCC with explicit n0_m0 true. This tool does not emit a predicted 5-year disease-specific survival; historical cohort percentages in Zisman 2002 are published cohort results, not a calculated field. ## Formula ``` UISS localized N0M0 (Zisman 2002): low_risk if t_stage t1 AND fuhrman_grade in {1, 2} AND ecog 0; high_risk if (t_stage t3 AND fuhrman_grade in {2, 3, 4} AND ecog >= 1) OR t_stage t4; else intermediate_risk. Requires surgically resected unilateral RCC with 1997 pathological T and explicit N0M0. Not 2001 five-group I-V. Not metastatic UISS. Not SSIGN. ``` ## Citation [Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma](https://doi.org/10.1200/JCO.2002.05.111) Zisman A, Pantuck AJ, Wieder J, Chao DH, Dorey F, Said JW, deKernion JB, Figlin RA, Belldegrun AS J Clin Oncol. 2002;20(23):4559-4566 DOI: [10.1200/JCO.2002.05.111](https://doi.org/10.1200/JCO.2002.05.111) ## Worked example ### T1 Fuhrman 1 ECOG 0 is low risk Given: `ecog=0, fuhrman_grade=1, n0_m0=true, t_stage=t1` 1. t_stage t1, n0_m0 true, fuhrman_grade 1, ecog 0 2. T1 AND Fuhrman 1-2 AND ECOG 0 → uiss_group low_risk ### T4 is high risk Given: `ecog=0, fuhrman_grade=1, n0_m0=true, t_stage=t4` 1. t_stage t4, n0_m0 true, fuhrman_grade 1, ecog 0 2. Any T4 is high_risk regardless of Fuhrman or ECOG ## Also searched as - UISS - UCLA Integrated Staging System - Zisman UISS - Zisman 2002 - localized RCC UISS - N0M0 UISS - renal cell carcinoma UISS - UISS low intermediate high ## Parameters - `t_stage` (string, required): 1997 pathological T as assigned by the caller (Zisman 2002 localized UISS). t1, t2, t3, or t4. Caller maps T1a/T1b to t1. magent does not assign TNM or read slides. - `n0_m0` (boolean, required): Must be true: surgically resected unilateral RCC that is node-negative and metastasis-negative (Zisman 2002 localized N0M0 UISS). N-positive or M-positive disease is out of scope. Not metastatic UISS. - `fuhrman_grade` (integer, required): Fuhrman 1982 nuclear grade 1-4 as assigned by the caller (same parsing as Fuhrman). Integer 1-4 only; reject 0, 5, 1.5, and roman I. magent does not read slides. - `ecog` (integer, required): Oken 1982 ECOG performance status 0-4 as assigned by the caller. Grade 5 (dead) is not scored. magent does not observe the patient. ## 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/uiss` 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": [ { "ecog": "0", "fuhrman_grade": "1", "n0_m0": "true", "t_stage": "t1" }, { "ecog": "0", "fuhrman_grade": "1", "n0_m0": "true", "t_stage": "t1" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/uiss Example 200: ```json { "count": 2, "path": "/api/calc/uiss", "items": [ { "components": [ { "value": "t1", "factor": "t_stage", "met": true }, { "factor": "n0_m0", "met": true }, { "value": 1, "factor": "fuhrman_grade", "met": true }, { "value": 0, "factor": "ecog", "met": true }, { "factor": "low_risk", "met": true }, { "factor": "intermediate_risk", "met": false }, { "factor": "high_risk", "met": 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": "Zisman A, Pantuck AJ, Wieder J, Chao DH, Dorey F, Said JW, deKernion JB, Figlin RA, Belldegrun AS", "doi": "10.1200/JCO.2002.05.111", "id": "zisman-2002", "pmid": "12454113", "source": "J Clin Oncol. 2002;20(23):4559-4566", "title": "Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma" }, "formula": "uiss", "formula_expression": "UISS localized N0M0 (Zisman 2002): low_risk if t_stage t1 AND fuhrman_grade in {1, 2} AND ecog 0; high_risk if (t_stage t3 AND fuhrman_grade in {2, 3, 4} AND ecog >= 1) OR t_stage t4; else intermediate_risk. Requires surgically resected unilateral RCC with 1997 pathological T and explicit N0M0. Not 2001 five-group I-V. Not metastatic UISS. Not SSIGN.", "ecog": 0, "fuhrman_grade": 1, "n0_m0": true, "t_stage": "t1", "uiss_group": "low_risk" }, { "components": [ { "value": "t1", "factor": "t_stage", "met": true }, { "factor": "n0_m0", "met": true }, { "value": 1, "factor": "fuhrman_grade", "met": true }, { "value": 0, "factor": "ecog", "met": true }, { "factor": "low_risk", "met": true }, { "factor": "intermediate_risk", "met": false }, { "factor": "high_risk", "met": 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": "Zisman A, Pantuck AJ, Wieder J, Chao DH, Dorey F, Said JW, deKernion JB, Figlin RA, Belldegrun AS", "doi": "10.1200/JCO.2002.05.111", "id": "zisman-2002", "pmid": "12454113", "source": "J Clin Oncol. 2002;20(23):4559-4566", "title": "Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma" }, "formula": "uiss", "formula_expression": "UISS localized N0M0 (Zisman 2002): low_risk if t_stage t1 AND fuhrman_grade in {1, 2} AND ecog 0; high_risk if (t_stage t3 AND fuhrman_grade in {2, 3, 4} AND ecog >= 1) OR t_stage t4; else intermediate_risk. Requires surgically resected unilateral RCC with 1997 pathological T and explicit N0M0. Not 2001 five-group I-V. Not metastatic UISS. Not SSIGN.", "ecog": 0, "fuhrman_grade": 1, "n0_m0": true, "t_stage": "t1", "uiss_group": "low_risk" } ] } ``` ## Response fields - `formula` (string): uiss - `formula_expression` (string): Published Zisman 2002 localized N0M0 three-group rule - `t_stage` (string): Caller-assigned 1997 pathological T used (t1, t2, t3, or t4) - `n0_m0` (boolean): true; N-positive or M-positive is rejected before scoring - `fuhrman_grade` (integer): Caller-assigned Fuhrman 1982 nuclear grade 1-4 - `ecog` (integer): Caller-assigned Oken 1982 ECOG grade 0-4 - `uiss_group` (string): low_risk, intermediate_risk, or high_risk (Zisman 2002 localized N0M0). Not a 5-year DSS prediction. Not 2001 I-V. Not SSIGN. - `components` (array): Tree rows for t_stage, n0_m0, fuhrman_grade, ecog, and exclusive low_risk, intermediate_risk, high_risk with factor and met - `citation` (object): Zisman 2002 J Clin Oncol citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": "t1", "factor": "t_stage", "met": true }, { "factor": "n0_m0", "met": true }, { "value": 1, "factor": "fuhrman_grade", "met": true }, { "value": 0, "factor": "ecog", "met": true }, { "factor": "low_risk", "met": true }, { "factor": "intermediate_risk", "met": false }, { "factor": "high_risk", "met": 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": "Zisman A, Pantuck AJ, Wieder J, Chao DH, Dorey F, Said JW, deKernion JB, Figlin RA, Belldegrun AS", "doi": "10.1200/JCO.2002.05.111", "id": "zisman-2002", "pmid": "12454113", "source": "J Clin Oncol. 2002;20(23):4559-4566", "title": "Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma" }, "formula": "uiss", "formula_expression": "UISS localized N0M0 (Zisman 2002): low_risk if t_stage t1 AND fuhrman_grade in {1, 2} AND ecog 0; high_risk if (t_stage t3 AND fuhrman_grade in {2, 3, 4} AND ecog >= 1) OR t_stage t4; else intermediate_risk. Requires surgically resected unilateral RCC with 1997 pathological T and explicit N0M0. Not 2001 five-group I-V. Not metastatic UISS. Not SSIGN.", "ecog": 0, "fuhrman_grade": 1, "n0_m0": true, "t_stage": "t1", "uiss_group": "low_risk" } ``` ## Errors - HTTP 400 `invalid_uiss`: t_stage must be t1, t2, t3, or t4 (1997 TNM); n0_m0 must be true (Zisman 2002 localized N0M0 UISS). Not for N-positive or M-positive disease. Returned before settlement; you are not charged. - HTTP 400 `invalid_fuhrman`: fuhrman_grade must be 1, 2, 3, or 4 (Fuhrman 1982 nuclear grade). Returned before settlement; you are not charged. - HTTP 400 `invalid_ecog_ps`: ecog must be an integer from 0 to 4 (Oken 1982). Grade 5 (dead) is not scored. 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 - [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. - [Motzer](https://magentlab.com/docs/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. - [IMDC](https://magentlab.com/docs/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. - [ECOG](https://magentlab.com/docs/ecog) — Return the Oken 1982 ECOG performance status grade 0-4 from a caller-assigned integer, with a stable label. ## 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.