Preoperative multivariable prognostic model for prediction of nonorgan confined urothelial carcinoma of the upper urinary tract

Vitaly Margulis, Ramy F. Youssef, Pierre I. Karakiewicz, Yair Lotan, Christopher G. Wood, Richard Zigeuner, Eiji Kikuchi, Alon Weizer, Jay D. Raman, Mesut Remzi, Marco Roscigno, Francesco Montorsi, Christian Bolenz, Wassim Kassouf, Shahrokh F. Shariat

Research output: Contribution to journalArticle

128 Citations (Scopus)

Abstract

Purpose: We created a prognostic tool for the accurate preoperative prediction of nonorgan confined upper tract urothelial carcinoma. Materials and Methods: A computerized data bank containing comprehensive information on 1,453 patients who underwent radical nephroureterectomy at 13 academic institutions was generated and continuously updated. This study comprised a subset of 659 patients in whom all appropriate preoperative prognostic variables (age, gender, race, symptoms, Eastern Cooperative Oncology Group performance status, primary tumor location, tumor architecture, tumor grade and history of previous bladder cancer) were available for statistical analysis. A multivariable logistic regression model containing relevant clinicopathological variables addressed the prediction of nonorgan confined stage disease (T3-4 and/or N+) at radical nephroureterectomy. A backward step-down selection process was applied to achieve the most informative and parsimonious model. Internal validation was performed using 200 bootstrap resamples. Results: Pathological nonorgan confined urothelial carcinoma was found in 40% of patients. Grade, architecture and location of the tumor were independently associated with nonorgan confined disease. A nomogram including these 3 variables achieved 76.6% accuracy in predicting nonorgan confined upper tract urothelial cancer. Conclusions: We developed a simple and accurate prognostic tool for the prediction of locally advanced upper tract urothelial cancer. This preoperative prediction model can be used for designing clinical trials, selecting patients for preoperative systemic therapy and guiding the extent of concomitant lymph node dissection at nephroureterectomy.

Original languageEnglish
Pages (from-to)453-458
Number of pages6
JournalJournal of Urology
Volume184
Issue number2
DOIs
Publication statusPublished - 2010
Externally publishedYes

Fingerprint

Urinary Tract
Carcinoma
Neoplasms
Logistic Models
Nomograms
Lymph Node Excision
Urinary Bladder Neoplasms
Clinical Trials
Databases

Keywords

  • carcinoma
  • kidney
  • operative
  • prognosis
  • surgical procedures
  • transitional cell
  • ureter

ASJC Scopus subject areas

  • Urology

Cite this

Margulis, V., Youssef, R. F., Karakiewicz, P. I., Lotan, Y., Wood, C. G., Zigeuner, R., ... Shariat, S. F. (2010). Preoperative multivariable prognostic model for prediction of nonorgan confined urothelial carcinoma of the upper urinary tract. Journal of Urology, 184(2), 453-458. https://doi.org/10.1016/j.juro.2010.03.142

Preoperative multivariable prognostic model for prediction of nonorgan confined urothelial carcinoma of the upper urinary tract. / Margulis, Vitaly; Youssef, Ramy F.; Karakiewicz, Pierre I.; Lotan, Yair; Wood, Christopher G.; Zigeuner, Richard; Kikuchi, Eiji; Weizer, Alon; Raman, Jay D.; Remzi, Mesut; Roscigno, Marco; Montorsi, Francesco; Bolenz, Christian; Kassouf, Wassim; Shariat, Shahrokh F.

In: Journal of Urology, Vol. 184, No. 2, 2010, p. 453-458.

Research output: Contribution to journalArticle

Margulis, V, Youssef, RF, Karakiewicz, PI, Lotan, Y, Wood, CG, Zigeuner, R, Kikuchi, E, Weizer, A, Raman, JD, Remzi, M, Roscigno, M, Montorsi, F, Bolenz, C, Kassouf, W & Shariat, SF 2010, 'Preoperative multivariable prognostic model for prediction of nonorgan confined urothelial carcinoma of the upper urinary tract', Journal of Urology, vol. 184, no. 2, pp. 453-458. https://doi.org/10.1016/j.juro.2010.03.142
Margulis, Vitaly ; Youssef, Ramy F. ; Karakiewicz, Pierre I. ; Lotan, Yair ; Wood, Christopher G. ; Zigeuner, Richard ; Kikuchi, Eiji ; Weizer, Alon ; Raman, Jay D. ; Remzi, Mesut ; Roscigno, Marco ; Montorsi, Francesco ; Bolenz, Christian ; Kassouf, Wassim ; Shariat, Shahrokh F. / Preoperative multivariable prognostic model for prediction of nonorgan confined urothelial carcinoma of the upper urinary tract. In: Journal of Urology. 2010 ; Vol. 184, No. 2. pp. 453-458.
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abstract = "Purpose: We created a prognostic tool for the accurate preoperative prediction of nonorgan confined upper tract urothelial carcinoma. Materials and Methods: A computerized data bank containing comprehensive information on 1,453 patients who underwent radical nephroureterectomy at 13 academic institutions was generated and continuously updated. This study comprised a subset of 659 patients in whom all appropriate preoperative prognostic variables (age, gender, race, symptoms, Eastern Cooperative Oncology Group performance status, primary tumor location, tumor architecture, tumor grade and history of previous bladder cancer) were available for statistical analysis. A multivariable logistic regression model containing relevant clinicopathological variables addressed the prediction of nonorgan confined stage disease (T3-4 and/or N+) at radical nephroureterectomy. A backward step-down selection process was applied to achieve the most informative and parsimonious model. Internal validation was performed using 200 bootstrap resamples. Results: Pathological nonorgan confined urothelial carcinoma was found in 40{\%} of patients. Grade, architecture and location of the tumor were independently associated with nonorgan confined disease. A nomogram including these 3 variables achieved 76.6{\%} accuracy in predicting nonorgan confined upper tract urothelial cancer. Conclusions: We developed a simple and accurate prognostic tool for the prediction of locally advanced upper tract urothelial cancer. This preoperative prediction model can be used for designing clinical trials, selecting patients for preoperative systemic therapy and guiding the extent of concomitant lymph node dissection at nephroureterectomy.",
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T1 - Preoperative multivariable prognostic model for prediction of nonorgan confined urothelial carcinoma of the upper urinary tract

AU - Margulis, Vitaly

AU - Youssef, Ramy F.

AU - Karakiewicz, Pierre I.

AU - Lotan, Yair

AU - Wood, Christopher G.

AU - Zigeuner, Richard

AU - Kikuchi, Eiji

AU - Weizer, Alon

AU - Raman, Jay D.

AU - Remzi, Mesut

AU - Roscigno, Marco

AU - Montorsi, Francesco

AU - Bolenz, Christian

AU - Kassouf, Wassim

AU - Shariat, Shahrokh F.

PY - 2010

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N2 - Purpose: We created a prognostic tool for the accurate preoperative prediction of nonorgan confined upper tract urothelial carcinoma. Materials and Methods: A computerized data bank containing comprehensive information on 1,453 patients who underwent radical nephroureterectomy at 13 academic institutions was generated and continuously updated. This study comprised a subset of 659 patients in whom all appropriate preoperative prognostic variables (age, gender, race, symptoms, Eastern Cooperative Oncology Group performance status, primary tumor location, tumor architecture, tumor grade and history of previous bladder cancer) were available for statistical analysis. A multivariable logistic regression model containing relevant clinicopathological variables addressed the prediction of nonorgan confined stage disease (T3-4 and/or N+) at radical nephroureterectomy. A backward step-down selection process was applied to achieve the most informative and parsimonious model. Internal validation was performed using 200 bootstrap resamples. Results: Pathological nonorgan confined urothelial carcinoma was found in 40% of patients. Grade, architecture and location of the tumor were independently associated with nonorgan confined disease. A nomogram including these 3 variables achieved 76.6% accuracy in predicting nonorgan confined upper tract urothelial cancer. Conclusions: We developed a simple and accurate prognostic tool for the prediction of locally advanced upper tract urothelial cancer. This preoperative prediction model can be used for designing clinical trials, selecting patients for preoperative systemic therapy and guiding the extent of concomitant lymph node dissection at nephroureterectomy.

AB - Purpose: We created a prognostic tool for the accurate preoperative prediction of nonorgan confined upper tract urothelial carcinoma. Materials and Methods: A computerized data bank containing comprehensive information on 1,453 patients who underwent radical nephroureterectomy at 13 academic institutions was generated and continuously updated. This study comprised a subset of 659 patients in whom all appropriate preoperative prognostic variables (age, gender, race, symptoms, Eastern Cooperative Oncology Group performance status, primary tumor location, tumor architecture, tumor grade and history of previous bladder cancer) were available for statistical analysis. A multivariable logistic regression model containing relevant clinicopathological variables addressed the prediction of nonorgan confined stage disease (T3-4 and/or N+) at radical nephroureterectomy. A backward step-down selection process was applied to achieve the most informative and parsimonious model. Internal validation was performed using 200 bootstrap resamples. Results: Pathological nonorgan confined urothelial carcinoma was found in 40% of patients. Grade, architecture and location of the tumor were independently associated with nonorgan confined disease. A nomogram including these 3 variables achieved 76.6% accuracy in predicting nonorgan confined upper tract urothelial cancer. Conclusions: We developed a simple and accurate prognostic tool for the prediction of locally advanced upper tract urothelial cancer. This preoperative prediction model can be used for designing clinical trials, selecting patients for preoperative systemic therapy and guiding the extent of concomitant lymph node dissection at nephroureterectomy.

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