PMID- 24119175
OWN - NLM
STAT- MEDLINE
DCOM- 20140922
LR  - 20140729
IS  - 1464-410X (Electronic)
IS  - 1464-4096 (Linking)
VI  - 114
IP  - 2
DP  - 2014 Aug
TI  - External validation of preoperative and postoperative nomograms for prediction of 
      cancer-specific survival, overall survival and recurrence after robot-assisted 
      radical cystectomy for urothelial carcinoma of the bladder.
PG  - 253-60
LID - 10.1111/bju.12484 [doi]
AB  - OBJECTIVE: To externally validate currently available bladder cancer nomograms 
      for prediction of all-cause survival (ACS), cancer-specific survival (CSS), 
      other-cause mortality (OCM) and progression-free survival (PFS). PATIENTS AND 
      METHODS: Retrospective analysis of a prospectively maintained database of 282 
      patients who underwent robot-assisted radical cystectomy (RARC) at a single 
      institution was performed. The Bladder Cancer Research Consortium (BCRC), 
      International Bladder Cancer Nomogram Consortium (IBCNC) and Lughezzani nomograms 
      were used for external validation, and evaluation for accuracy at predicting 
      oncological outcomes. The 2- and 5-year oncological outcomes were compared, and 
      nomogram performance was evaluated through measurement of the concordance 
      (c-index) between nomogram-derived predicted oncological outcomes and observed 
      oncological outcomes. RESULTS: The median (range) patient age was 70 (36-90) 
      years. At a mean follow-up of 20 months, local or distant disease recurrence 
      developed in 30% of patients. With an overall mortality rate of 33%, 17% died 
      from bladder cancer. The actuarial 2- and 5-year PFS after RARC was 62% (95% 
      confidence interval [CI] 54-68) and 55% (95% CI 46-63), respectively. The 
      actuarial 2- and 5-year ACS was 66% (95% CI 59-72) and 47% (95% CI 37-55), 
      respectively, and the 2- and 5-year CSS was 81% (95% CI 74-86) and 67% (95% CI 
      57-76), respectively. The PFS c-index for IBCNC was 0.70 at 5 years, and for BCRC 
      was 0.77 at both the 2 and 5 years. The accuracy of ACS and CSS prediction was 
      evaluated using the BCRC and Lughezzani nomograms. Using the BCRC nomogram, 
      c-indices of for 2- and 5-year ACS were each 0.73 and c-indices for 2- and 5-year 
      CSS were 0.70 each. The performance of Lughezzani nomogram for 5-year ACS, 
      cancer-specific mortality and OCM were 0.73, 0.72 and 0.40, respectively. The 
      BCRC nomogram prediction of advanced pathological stage and lymph node metastasis 
      was modest, with c-indices of 0.66 and 0.61, respectively. CONCLUSIONS: Bladder 
      cancer nomograms available from the current open RC literature adequately predict 
      ACS, CSS and PFS after RARC. However, prediction of advanced tumour stage and 
      lymph node metastasis was modest and the Lughezzani nomogram failed to predict 
      OCM.
CI  - (c) 2013 The Authors. BJU International (c) 2013 BJU International.
FAU - Al-Daghmin, Ali
AU  - Al-Daghmin A
AD  - Department of Urology, Roswell Park Cancer Institute, Buffalo, NY, USA.
FAU - English, Stephen
AU  - English S
FAU - Kauffman, Eric C
AU  - Kauffman EC
FAU - Din, Rakeeba
AU  - Din R
FAU - Khan, Aabroo
AU  - Khan A
FAU - Syed, Johar R
AU  - Syed JR
FAU - Sztorc, Jenna
AU  - Sztorc J
FAU - Mehedint, Diana
AU  - Mehedint D
FAU - Sharif, Mohammad
AU  - Sharif M
FAU - Shi, Yi
AU  - Shi Y
FAU - Wilding, Gregory
AU  - Wilding G
FAU - Guru, Khurshid A
AU  - Guru KA
LA  - eng
PT  - Journal Article
DEP - 20140122
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
SB  - IM
MH  - *Actuarial Analysis
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma/*mortality/pathology/therapy
MH  - Cystectomy
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - *Nomograms
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Robotics
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Urinary Bladder Neoplasms/*mortality/pathology/therapy
OTO - NOTNLM
OT  - bladder cancer
OT  - nomograms
OT  - robot-assisted
EDAT- 2013/10/15 06:00
MHDA- 2014/09/23 06:00
CRDT- 2013/10/15 06:00
PHST- 2013/10/15 06:00 [entrez]
PHST- 2013/10/15 06:00 [pubmed]
PHST- 2014/09/23 06:00 [medline]
AID - 10.1111/bju.12484 [doi]
PST - ppublish
SO  - BJU Int. 2014 Aug;114(2):253-60. doi: 10.1111/bju.12484. Epub 2014 Jan 22.