1840 EXTERNAL VALIDATION OF BLADDER CANCER PREDICTIVE NOMOGRAMS FOR RECURRENCE, CANCER-FREE SURVIVAL, AND OVERALL SURVIVAL FOLLOWING RADICAL CYSTECTOMY

You have accessJournal of UrologyBladder Cancer: Invasive1 Apr 20111840 EXTERNAL VALIDATION OF BLADDER CANCER PREDICTIVE NOMOGRAMS FOR RECURRENCE, CANCER-FREE SURVIVAL, AND OVERALL SURVIVAL FOLLOWING RADICAL CYSTECTOMY Michael Brooks, Maxine Sun, Pierre Karakiewicz, Shahrok F. Shariat, Gilad E. Amiel, Seth P. Lerner, and Guilherme Godoy Michael BrooksMichael Brooks Houston, TX , Maxine SunMaxine Sun Montreal, Canada , Pierre KarakiewiczPierre Karakiewicz Montreal, Canada , Shahrok F. ShariatShahrok F. Shariat New York, NY , Gilad E. AmielGilad E. Amiel Houston, TX , Seth P. LernerSeth P. Lerner Houston, TX , and Guilherme GodoyGuilherme Godoy Houston, TX View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1873AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nomograms provide individualized risk predictions for patients as opposed to staging-based group risk predictions. Three previously published nomograms for patients following radical cystectomy (RC) for urothelial carcinoma (http://www.nomogram.org) have demonstrated superior accuracy in outcomes predications compared to AJCC staging. The goal of the present study is to validate the nomograms for prediction of recurrence (J Urol 176:1354, 2006), cancer-specific and overall survival (Clin Ca Res 12:6663, 2006), following RC and pelvic lymph node dissection (PLND) for urothelial carcinoma of the bladder. METHODS Two surgeons from a single institution performed 205 consecutive RC and extended PLND for bladder cancer from January 2003 to September 2009. 31 patients were excluded (12 due to non-transitional cell histology, 3 due to salvage surgery status, and 16 due to lack of sufficient data), leaving 174 patients with evaluable data for analysis. The data elements were those used in the original nomograms, including age, gender, pathological T stage, N stage, tumor grade, presence of carcinoma in situ and lymphovascular invasion, neoadjuvant chemotherapy, adjuvant chemotherapy and adjuvant radiation therapy. Model discrimination was measured using the receiver operating characteristics derived area under the curve (AUC). RESULTS At the time of treatment, median age was 69.1 years (interquartile range [IQR], 60.9, 74.7), 88.5% were male, and median follow-up for patients alive was 24 months (IQR, 11, 49). The majority of patients had muscle invasive disease (pT2, pT3 and pT4 in 16.7%, 29.9% and 10.3%, respectively) and high-grade tumors (78.7%); 24.1% had positive nodes (pN1=5.7% and pN2=18.4%). The patients received neoadjuvant and adjuvant chemotherapy in 9.2% and 31.6%, respectively. At the time of analysis, 44 had died, 29 patients of disease, and 34 patients had recurred; including 30 patients who died of disease, and 4 patients who were currently alive with disease. The AUC at 2, 5 and 8 years for recurrence, cancer-specific and overall survival were 77.6, 80.9, 79.4%, 82.2, 84.0, 84.9%, and 81.2, 82.0, and 82.5%, respectively. Nomograms overestimated predictions of all three endpoints. CONCLUSIONS The nomograms for bladder cancer recurrence, cancer-specific survival, and overall survival following RC and PLND performed well in this series, with accuracy comparable to the original series. These nomograms may be useful tools when counseling patients and for risk stratification in clinical trials. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e738 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Brooks Houston, TX More articles by this author Maxine Sun Montreal, Canada More articles by this author Pierre Karakiewicz Montreal, Canada More articles by this author Shahrok F. Shariat New York, NY More articles by this author Gilad E. Amiel Houston, TX More articles by this author Seth P. Lerner Houston, TX More articles by this author Guilherme Godoy 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.