Roupret, Morgan and Hupertan, Vincent and Seisen, Thomas and Colin, Pierre and Xylinas, Evanguelos and Yates, David R. and Fajkovic, Harun and Lotan, Yair and Raman, Jay D. and Zigeuner, Richard and Remzi, Mesut and Bolenz, Christian and Novara, Giacomo and Kassouf, Wassim and Ouzzane, Adil and Rozet, Francois and Cussenot, Olivier and Martinez-Salamanca, Juan I. and Fritsche, Hans-Martin and Walton, Thomas J. and Wood, Christopher G. and Bensalah, Karim and Karakiewicz, Pierre I. and Montorsi, Francesco and Margulis, Vitaly and Shariat, Shahrokh F. (2013) Prediction of Cancer Specific Survival After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: Development of an Optimized Postoperative Nomogram Using Decision Curve Analysis. JOURNAL OF UROLOGY, 189 (5). pp. 1662-1669. ISSN 0022-5347,
Full text not available from this repository. (Request a copy)Abstract
Purpose: We conceived and proposed a unique and optimized nomogram to predict cancer specific survival after radical nephroureterectomy in patients with upper tract urothelial carcinoma by merging the 2 largest multicenter data sets reported in this population. Materials and Methods: The international and the French national collaborative groups on upper tract urothelial carcinoma pooled data on 3,387 patients treated with radical nephroureterectomy for whom full data for nomogram development were available. The merged study population was randomly split into the development cohort (2,371) and the external validation cohort (1,016). Cox regressions were used for univariable and multivariable analyses, and to build different models. The ultimate reduced nomogram was assessed using Harrell's concordance index (c-index) and decision curve analysis. Results: Of the 2,371 patients in the nomogram development cohort 510 (21.5%) died of upper tract urothelial carcinoma during followup. The actuarial cancer specific survival probability at 5 years was 73.7% (95% CI 71.9-75.6). Decision curve analysis revealed that the use of the best model was associated with benefit gains relative to the prediction of cancer specific survival. The optimized nomogram included only 5 variables associated with cancer specific survival on multivariable analysis, those of age (p = 0.001), T stage (p <0.001), N stage (p = 0.001), architecture (p = 0.02) and lymphovascular invasion (p = 0.001). The discriminative accuracy of the nomogram was 0.8 (95% CI 0.77-0.86). Conclusions: Using standard pathological features obtained from the largest data set of upper tract urothelial carcinomas worldwide, we devised and validated an accurate and ultimate nomogram, superior to any single clinical variable, for predicting cancer specific survival after radical nephroureterectomy.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PREOPERATIVE NOMOGRAM; PROGNOSTIC MODELS; OUTCOMES; PROSTATECTOMY; VALIDATION; RECURRENCE; ureter; kidney pelvis; carcinoma, transitional cell; survival; nomograms |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Apr 2020 11:57 |
| Last Modified: | 09 Apr 2020 11:57 |
| URI: | https://pred.uni-regensburg.de/id/eprint/16704 |
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