486 LYMPH NODE DENSITY: UTILITY IN STRATIFYING PATIENTS FOR ADJUVANT THERAPY AFTER RADICAL CYSTECTOMY FOR BLADDER CANCER
Notice bibliographique
Résumé
You have accessJournal of UrologyUrothelial Cancer: Medical & Surgical Therapy1 Apr 2011486 LYMPH NODE DENSITY: UTILITY IN STRATIFYING PATIENTS FOR ADJUVANT THERAPY AFTER RADICAL CYSTECTOMY FOR BLADDER CANCER Eugene Lee, Harry Herr, Wassim Kassouf, Mark Munsell, H. Barton Grossman, Colin Dinney, and Ashish Kamat Eugene LeeEugene Lee Houston, TX More articles by this author , Harry HerrHarry Herr New York, NY More articles by this author , Wassim KassoufWassim Kassouf Montreal, Canada More articles by this author , Mark MunsellMark Munsell Houston, TX More articles by this author , H. Barton GrossmanH. Barton Grossman Houston, TX More articles by this author , Colin DinneyColin Dinney Houston, TX More articles by this author , and Ashish KamatAshish Kamat Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.581AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with nodal metastasis detected at radical cystectomy for bladder cancer have an overall poor prognosis and are often considered for adjuvant chemotherapy. We explore the utility of lymph node density (LND) for stratifying these patients based on disease specific survival (DSS). METHODS From a pooled database from M. D. Anderson Cancer Center (MDACC) and Memorial Sloan-Kettering Cancer Center (MSKCC), we identified 248 patients with nodal metastasis after radical cystectomy (performed from 1979–2003). Of these patients, 143 had at least 8 nodes evaluable (surrogate marker for “adequate” nodal dissection) and did not receive neoadjuvant or adjuvant chemotherapy. The Kaplan-Meier product-limit estimator and Cox proportional hazards regression model were used to assess DSS at different LND cutoffs. RESULTS The mean and median follow-up for the patients was 45.9 months and 30.0 months, respectively (range 0.5 to 122). For those patients alive at last follow-up, the median follow-up was 66.0 months. There were 81 patients who died of their disease with an overall median DSS of 39.5 months. The 2-year DSS was 62.0% (95% CI 53.2%–69.6%), and the 5-year DSS was 38.1% (95% CI 29.4% to 46.6%). DSS was intimately linked to LND at the 10%, 15%, 20%, 25%, 30%, and 35% cut points (p<0.001). Patients with LND < 15% (n=66 with 23 deaths from disease) had a 5 year DSS of 61.1%. Conversely, patients with a LND > 15% (n=77 with 58 deaths from disease) had a 5 yr DSS of 19.2%. Survival worsened as LND increased, such that only 4% of patients with LND > 35% (n=26 with 24 deaths from disease) were alive at 5 years. CONCLUSIONS In the context of an adequate node dissection, LND may be used as a tool to risk-stratify patients and select appropriate candidates for adjuvant chemotherapy. Furthermore, this concept would be useful when reporting the results of ongoing trials of adjuvant chemotherapy. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e198 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eugene Lee Houston, TX More articles by this author Harry Herr New York, NY More articles by this author Wassim Kassouf Montreal, Canada More articles by this author Mark Munsell Houston, TX More articles by this author H. Barton Grossman Houston, TX More articles by this author Colin Dinney Houston, TX More articles by this author Ashish Kamat Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».