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Multicenter Study
. 2024 Dec;31(12):1414-1422.
doi: 10.1111/iju.15585. Epub 2024 Sep 18.

Development and validation of a model to predict the outcomes of radical cystectomy in patients with bladder cancer

Wataru Fukuokaya  1   2 , Jun Miki  1   2 , Rikiya Taoka  3 , Ryoichi Saito  4 , Yoshiyuki Matsui  5 , Shingo Hatakeyama  6 , Takashi Kawahara  7 , Ayumu Matsuda  5 , Taketo Kawai  8   9 , Minoru Kato  10 , Tomokazu Sazuka  11 , Takeshi Sano  4 , Fumihiko Urabe  2   12 , Soki Kashima  13 , Hirohito Naito  14 , Yoji Murakami  15 , Naotaka Nishiyama  16 , Hiroyuki Nishiyama  7 , Hiroshi Kitamura  16 , Takahiro Kimura  2
Affiliations
Multicenter Study

Development and validation of a model to predict the outcomes of radical cystectomy in patients with bladder cancer

Wataru Fukuokaya et al. Int J Urol. 2024 Dec.

Abstract

Objectives: This study aims to develop a prognostic model that estimates the post-operative risk of cancer-specific mortality in patients with bladder cancer who underwent radical cystectomy (RC).

Methods: We analyzed the data from patients with bladder cancer who had undergone radical cystectomy without receiving adjuvant chemotherapy across 36 institutions in the Japan Urological Oncology Group. The data were randomly split into training (N = 1348) and validation sets (N = 674) in a 2:1 ratio. Twenty-five variables were analyzed, and a multivariable Cox regression model predicting cancer-specific mortality was developed and validated. Prognostic scores were categorized into good and poor prognostic groups based on the upper tertile. The performance of the model was compared against the CheckMate 274 risk classification as a reference, which is used for determining the indication of adjuvant nivolumab therapy.

Results: The final model incorporated eight variables. In the validation set, it outperformed the CheckMate 274 risk classification with superior time-dependent area under the curves (5-year: 0.81 vs. 0.67) and was well-calibrated. Furthermore, our model reclassified 27.8% of patients categorized as high-risk by the CheckMate 274 risk classification into the good prognosis group.

Conclusions: We developed and validated a prognostic model for patients with bladder cancer who underwent RC. This model will be beneficial in identifying patients with poor prognosis and those who are potential candidates for clinical trials of adjuvant therapy.

Keywords: bladder cancer; non‐urinary tract recurrence‐free survival; overall survival; prognostic model; radical cystectomy.

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References

REFERENCES

    1. Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S, et al. Radical cystectomy in the treatment of invasive bladder cancer: long‐term results in 1054 patients. J Clin Oncol. 2001;19:666–675.
    1. Karakiewicz PI, Shariat SF, Palapattu GS, Gilad AE, Lotan Y, Rogers CG, et al. Nomogram for predicting disease recurrence after radical cystectomy for transitional cell carcinoma of the bladder. J Urol. 2006;176:1354–1361.
    1. Yang Z, Bai Y, Liu M, Hu X, Han P. Development and validation of a prognostic nomogram for predicting cancer‐specific survival after radical cystectomy in patients with bladder cancer: a population‐based study. Cancer Med. 2020;9:9303–9314.
    1. Todenhöfer T, Renninger M, Schwentner C, Stenzl A, Gakis G. A new prognostic model for cancer‐specific survival after radical cystectomy including pretreatment thrombocytosis and standard pathological risk factors. BJU Int. 2012;110:E533–E540.
    1. Eisenberg MS, Boorjian SA, Cheville JC, Thompson RH, Thapa P, Kaushik D, et al. The SPARC score: a multifactorial outcome prediction model for patients undergoing radical cystectomy for bladder cancer. J Urol. 2013;190:2005–2010.

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