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Prediction of Cancer Specific Survival After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: Development of an Optimized Postoperative Nomogram Using Decision Curve Analysis

Rouprêt, Morgan ; Hupertan, Vincent ; Seisen, Thomas ; Colin, Pierre ; Xylinas, Evanguelos ; Yates, David R ; Fajkovic, Harun ; Lotan, Yair ; Raman, Jay D ; Zigeuner, Richard ; Remzi, Mesut ; Bolenz, Christian ; Novara, Giacomo ; Kassouf, Wassim ; Ouzzane, Adil ; Rozet, François ; Cussenot, Olivier ; Martinez-Salamanca, Juan I ; Fritsche, Hans-Martin ; Walton, Thomas J ; Wood, Christopher G ; Bensalah, Karim ; Karakiewicz, Pierre I ; Montorsi, Francesco ; Margulis, Vitaly ; Shariat, Shahrokh F

The Journal of urology, 2013-05, Vol.189 (5), p.1662-1669 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
Prediction of Cancer Specific Survival After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: Development of an Optimized Postoperative Nomogram Using Decision Curve Analysis
Autor: Rouprêt, Morgan ; Hupertan, Vincent ; Seisen, Thomas ; Colin, Pierre ; Xylinas, Evanguelos ; Yates, David R ; Fajkovic, Harun ; Lotan, Yair ; Raman, Jay D ; Zigeuner, Richard ; Remzi, Mesut ; Bolenz, Christian ; Novara, Giacomo ; Kassouf, Wassim ; Ouzzane, Adil ; Rozet, François ; Cussenot, Olivier ; Martinez-Salamanca, Juan I ; Fritsche, Hans-Martin ; Walton, Thomas J ; Wood, Christopher G ; Bensalah, Karim ; Karakiewicz, Pierre I ; Montorsi, Francesco ; Margulis, Vitaly ; Shariat, Shahrokh F
Assuntos: Aged ; Aged, 80 and over ; Bioengineering ; Biological and medical sciences ; Carcinoma, Transitional Cell ; Carcinoma, Transitional Cell - mortality ; Carcinoma, Transitional Cell - surgery ; Decision Support Techniques ; Female ; Human health and pathology ; Humans ; Kidney Neoplasms ; Kidney Neoplasms - mortality ; Kidney Neoplasms - surgery ; Kidney Pelvis ; Kidney Pelvis - surgery ; Life Sciences ; Male ; Medical sciences ; Middle Aged ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Nephrectomy ; Nephrectomy - methods ; Nephrology. Urinary tract diseases ; Nomograms ; Retrospective Studies ; survival ; Tumors ; Tumors of the urinary system ; Ureter ; Ureter - surgery ; Ureteral Neoplasms ; Ureteral Neoplasms - mortality ; Ureteral Neoplasms - surgery ; Urinary tract. Prostate gland ; Urology ; Urology and Nephrology
É parte de: The Journal of urology, 2013-05, Vol.189 (5), p.1662-1669
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: 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.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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Prediction of Cancer Specific Survival After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: Development of an Optimized Postoperative Nomogram Using Decision Curve Analysis

New York, NY: Elsevier Inc

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