Erschienen in:
01.10.2015 | Original Article
Development and external validation of nomograms predicting disease-free and cancer-specific survival after radical cystectomy
verfasst von:
Giuseppe Simone, Marco Bianchi, Diana Giannarelli, Siamak Daneshmand, Rocco Papalia, Mariaconsiglia Ferriero, Salvatore Guaglianone, Steno Sentinelli, Renzo Colombo, Francesco Montorsi, Devis Collura, Giovanni Muto, Giacomo Novara, Rodolfo Hurle, Michael Rink, Margit Fisch, Hassan Abol-Enein, Gus Miranda, Mihir Desai, Inderbir Gill, Michele Gallucci
Erschienen in:
World Journal of Urology
|
Ausgabe 10/2015
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Abstract
Purpose
To develop two nomograms predicting disease-free survival (DFS) and cancer-specific survival (CSS) and to externally validate them in multiple series.
Methods
Prospectively collected data from a single-centre series of 818 consecutive patients who underwent RC and PLND were used to build the nomogram. External validation was performed in 3,173 patients from 7 centres worldwide. Time to recurrence and to cancer-specific death were addressed with univariable and multivariable analyses. Nomograms were built to predict 2-, 5- and 8-year DFS and CSS probabilities. Predictive accuracy was quantified using the concordance index.
Results
Age, pathologic T stage, lymph-node density and extent of PLND were independent predictors of DFS and CSS (p < 0.05). Discrimination accuracies for DFS and CSS at 2, 5 and 8 years were 0.81, 0.8, 0.79 and 0.82, 0.81, 0.8, respectively, with a slight overestimation at calibration plots beyond 24 months. In the external series, predictive accuracies for DFS and CSS at 2, 5 and 8 years were 0.83, 0.82, 0.82 and 0.85, 0.85, 0.83 for European centres; 0.73, 0.72, 0.71 and 0.80, 0.74, 0.68 for African series; 0.76, 0.74, 0.71 and 0.79, 0.76, 0.73 for American series.
Conclusions
These nomograms developed from a contemporary series are simple clinical tools and provide optimal oncologic outcome prediction in all external cohorts.