Postoperative nomogram predicting risk of recurrence after radical cystectomy for bladder cancer

Bernard H. Bochner, Guido Dalbagni, Michael W. Kattan, Paul Fearn, Kinjal Vora, Song Seo Hee, Lauren Zoref, Hassan Abol-Enein, Mohamed A. Ghoneim, Peter T. Scardino, Dean Bajorin, Donald G. Skinner, John P. Stein, Gus Miranda, Jürgen E. Gschwend, Bjoern G. Volkmer, Richard E. Hautmann, Sam Chang, Michael Cookson, Joseph A. Smith & 15 others George Thalman, Urs E. Studer, Cheryl T. Lee, James Montie, David Wood, Juan Palou, Yyes Fradet, Louis LaCombe, Pierre Simard, Mark P. Schoenberg, Seth Lerner, Amnon Vazina, PierFrancesco Bassi, Masaru Murai, Eiji Kikuchi

Research output: Contribution to journalArticle

268 Citations (Scopus)

Abstract

Purpose: Radical cystectomy and pelvic lymphadenectomy (PLND) remains the standard treatment for localized and regionally advanced invasive bladder cancers. We have constructed an international bladder cancer database from centers of excellence in the management of bladder cancer consisting of patients treated with radical cystectomy and PLND. The goal of this study was the development of a prognostic outcomes nomogram to predict the 5-year disease recurrence risk after radical cystectomy. Patients and Methods: Institutional radical cystectomy databases containing detailed information on bladder cancer patients were obtained from 12 centers of excellence worldwide. Data were collected on more than 9,000 postoperative patients and combined into a relational database formatted with patient characteristics, pathologic details of the pre- and postcystectomy specimens, and recurrence and survival status. Patients with available information for all selected study criteria were included in the formation of the final prognostic nomogram designed to predict 5-year progression-free probability. Results: The final nomogram included information on patient age, sex, time from diagnosis to surgery, pathologic tumor stage and grade, tumor histologic subtype, and regional lymph node status. The predictive accuracy of the constructed international nomogram (concordance index, 0.75) was significantly better than standard American Joint Committee on Cancer TNM (concordance index, 0.68; P < .001) or standard pathologic subgroupings (concordance index, 0.62; P < .001). Conclusion: We have developed an international bladder cancer nomogram predicting recurrence risk after radical cystectomy for bladder cancer. The nomogram outperformed prognostic models that use standard pathologic subgroupings and should improve our ability to provide accurate risk assessments to patients after the surgical management of bladder cancer.

Original languageEnglish
Pages (from-to)3967-3972
Number of pages6
JournalJournal of Clinical Oncology
Volume24
Issue number24
DOIs
Publication statusPublished - 2006 Aug 20

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Nomograms
Cystectomy
Urinary Bladder Neoplasms
Recurrence
Databases
Neoplasms
Lymph Node Excision
Lymph Nodes
Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Bochner, B. H., Dalbagni, G., Kattan, M. W., Fearn, P., Vora, K., Hee, S. S., ... Kikuchi, E. (2006). Postoperative nomogram predicting risk of recurrence after radical cystectomy for bladder cancer. Journal of Clinical Oncology, 24(24), 3967-3972. https://doi.org/10.1200/JCO.2005.05.3884

Postoperative nomogram predicting risk of recurrence after radical cystectomy for bladder cancer. / Bochner, Bernard H.; Dalbagni, Guido; Kattan, Michael W.; Fearn, Paul; Vora, Kinjal; Hee, Song Seo; Zoref, Lauren; Abol-Enein, Hassan; Ghoneim, Mohamed A.; Scardino, Peter T.; Bajorin, Dean; Skinner, Donald G.; Stein, John P.; Miranda, Gus; Gschwend, Jürgen E.; Volkmer, Bjoern G.; Hautmann, Richard E.; Chang, Sam; Cookson, Michael; Smith, Joseph A.; Thalman, George; Studer, Urs E.; Lee, Cheryl T.; Montie, James; Wood, David; Palou, Juan; Fradet, Yyes; LaCombe, Louis; Simard, Pierre; Schoenberg, Mark P.; Lerner, Seth; Vazina, Amnon; Bassi, PierFrancesco; Murai, Masaru; Kikuchi, Eiji.

In: Journal of Clinical Oncology, Vol. 24, No. 24, 20.08.2006, p. 3967-3972.

Research output: Contribution to journalArticle

Bochner, BH, Dalbagni, G, Kattan, MW, Fearn, P, Vora, K, Hee, SS, Zoref, L, Abol-Enein, H, Ghoneim, MA, Scardino, PT, Bajorin, D, Skinner, DG, Stein, JP, Miranda, G, Gschwend, JE, Volkmer, BG, Hautmann, RE, Chang, S, Cookson, M, Smith, JA, Thalman, G, Studer, UE, Lee, CT, Montie, J, Wood, D, Palou, J, Fradet, Y, LaCombe, L, Simard, P, Schoenberg, MP, Lerner, S, Vazina, A, Bassi, P, Murai, M & Kikuchi, E 2006, 'Postoperative nomogram predicting risk of recurrence after radical cystectomy for bladder cancer', Journal of Clinical Oncology, vol. 24, no. 24, pp. 3967-3972. https://doi.org/10.1200/JCO.2005.05.3884
Bochner, Bernard H. ; Dalbagni, Guido ; Kattan, Michael W. ; Fearn, Paul ; Vora, Kinjal ; Hee, Song Seo ; Zoref, Lauren ; Abol-Enein, Hassan ; Ghoneim, Mohamed A. ; Scardino, Peter T. ; Bajorin, Dean ; Skinner, Donald G. ; Stein, John P. ; Miranda, Gus ; Gschwend, Jürgen E. ; Volkmer, Bjoern G. ; Hautmann, Richard E. ; Chang, Sam ; Cookson, Michael ; Smith, Joseph A. ; Thalman, George ; Studer, Urs E. ; Lee, Cheryl T. ; Montie, James ; Wood, David ; Palou, Juan ; Fradet, Yyes ; LaCombe, Louis ; Simard, Pierre ; Schoenberg, Mark P. ; Lerner, Seth ; Vazina, Amnon ; Bassi, PierFrancesco ; Murai, Masaru ; Kikuchi, Eiji. / Postoperative nomogram predicting risk of recurrence after radical cystectomy for bladder cancer. In: Journal of Clinical Oncology. 2006 ; Vol. 24, No. 24. pp. 3967-3972.
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abstract = "Purpose: Radical cystectomy and pelvic lymphadenectomy (PLND) remains the standard treatment for localized and regionally advanced invasive bladder cancers. We have constructed an international bladder cancer database from centers of excellence in the management of bladder cancer consisting of patients treated with radical cystectomy and PLND. The goal of this study was the development of a prognostic outcomes nomogram to predict the 5-year disease recurrence risk after radical cystectomy. Patients and Methods: Institutional radical cystectomy databases containing detailed information on bladder cancer patients were obtained from 12 centers of excellence worldwide. Data were collected on more than 9,000 postoperative patients and combined into a relational database formatted with patient characteristics, pathologic details of the pre- and postcystectomy specimens, and recurrence and survival status. Patients with available information for all selected study criteria were included in the formation of the final prognostic nomogram designed to predict 5-year progression-free probability. Results: The final nomogram included information on patient age, sex, time from diagnosis to surgery, pathologic tumor stage and grade, tumor histologic subtype, and regional lymph node status. The predictive accuracy of the constructed international nomogram (concordance index, 0.75) was significantly better than standard American Joint Committee on Cancer TNM (concordance index, 0.68; P < .001) or standard pathologic subgroupings (concordance index, 0.62; P < .001). Conclusion: We have developed an international bladder cancer nomogram predicting recurrence risk after radical cystectomy for bladder cancer. The nomogram outperformed prognostic models that use standard pathologic subgroupings and should improve our ability to provide accurate risk assessments to patients after the surgical management of bladder cancer.",
author = "Bochner, {Bernard H.} and Guido Dalbagni and Kattan, {Michael W.} and Paul Fearn and Kinjal Vora and Hee, {Song Seo} and Lauren Zoref and Hassan Abol-Enein and Ghoneim, {Mohamed A.} and Scardino, {Peter T.} and Dean Bajorin and Skinner, {Donald G.} and Stein, {John P.} and Gus Miranda and Gschwend, {J{\"u}rgen E.} and Volkmer, {Bjoern G.} and Hautmann, {Richard E.} and Sam Chang and Michael Cookson and Smith, {Joseph A.} and George Thalman and Studer, {Urs E.} and Lee, {Cheryl T.} and James Montie and David Wood and Juan Palou and Yyes Fradet and Louis LaCombe and Pierre Simard and Schoenberg, {Mark P.} and Seth Lerner and Amnon Vazina and PierFrancesco Bassi and Masaru Murai and Eiji Kikuchi",
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T1 - Postoperative nomogram predicting risk of recurrence after radical cystectomy for bladder cancer

AU - Bochner, Bernard H.

AU - Dalbagni, Guido

AU - Kattan, Michael W.

AU - Fearn, Paul

AU - Vora, Kinjal

AU - Hee, Song Seo

AU - Zoref, Lauren

AU - Abol-Enein, Hassan

AU - Ghoneim, Mohamed A.

AU - Scardino, Peter T.

AU - Bajorin, Dean

AU - Skinner, Donald G.

AU - Stein, John P.

AU - Miranda, Gus

AU - Gschwend, Jürgen E.

AU - Volkmer, Bjoern G.

AU - Hautmann, Richard E.

AU - Chang, Sam

AU - Cookson, Michael

AU - Smith, Joseph A.

AU - Thalman, George

AU - Studer, Urs E.

AU - Lee, Cheryl T.

AU - Montie, James

AU - Wood, David

AU - Palou, Juan

AU - Fradet, Yyes

AU - LaCombe, Louis

AU - Simard, Pierre

AU - Schoenberg, Mark P.

AU - Lerner, Seth

AU - Vazina, Amnon

AU - Bassi, PierFrancesco

AU - Murai, Masaru

AU - Kikuchi, Eiji

PY - 2006/8/20

Y1 - 2006/8/20

N2 - Purpose: Radical cystectomy and pelvic lymphadenectomy (PLND) remains the standard treatment for localized and regionally advanced invasive bladder cancers. We have constructed an international bladder cancer database from centers of excellence in the management of bladder cancer consisting of patients treated with radical cystectomy and PLND. The goal of this study was the development of a prognostic outcomes nomogram to predict the 5-year disease recurrence risk after radical cystectomy. Patients and Methods: Institutional radical cystectomy databases containing detailed information on bladder cancer patients were obtained from 12 centers of excellence worldwide. Data were collected on more than 9,000 postoperative patients and combined into a relational database formatted with patient characteristics, pathologic details of the pre- and postcystectomy specimens, and recurrence and survival status. Patients with available information for all selected study criteria were included in the formation of the final prognostic nomogram designed to predict 5-year progression-free probability. Results: The final nomogram included information on patient age, sex, time from diagnosis to surgery, pathologic tumor stage and grade, tumor histologic subtype, and regional lymph node status. The predictive accuracy of the constructed international nomogram (concordance index, 0.75) was significantly better than standard American Joint Committee on Cancer TNM (concordance index, 0.68; P < .001) or standard pathologic subgroupings (concordance index, 0.62; P < .001). Conclusion: We have developed an international bladder cancer nomogram predicting recurrence risk after radical cystectomy for bladder cancer. The nomogram outperformed prognostic models that use standard pathologic subgroupings and should improve our ability to provide accurate risk assessments to patients after the surgical management of bladder cancer.

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