Nomogram based on baseline clinicopathological characteristics for predicting bladder cancer-specific survival to neoadjuvant chemotherapy in muscle-invasive bladder cancer.

Autor: Font A; Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, 08972, Barcelona, Spain. afont@iconcologia.net.; Badalona Applied Research Group in Oncology (B-ARGO), Institut Català d'Oncologia - Germans Trias i Pujol Research Institute, Badalona, Barcelona, Spain. afont@iconcologia.net., Domenech M; Medical Oncology Department, Xarxa Assistencial Universitària de Manresa, Barcelona, Spain., Buisan O; Urology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain., Lopez H; Urology Department, Xarxa Assistencial Universitària de Manresa, Barcelona, Spain., González A; Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, 08972, Barcelona, Spain., Etxaniz O; Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, 08972, Barcelona, Spain.; Badalona Applied Research Group in Oncology (B-ARGO), Institut Català d'Oncologia - Germans Trias i Pujol Research Institute, Badalona, Barcelona, Spain., Matas M; Medical Oncology Department, Xarxa Assistencial Universitària de Manresa, Barcelona, Spain., Elias X; Urology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain., Gomez M; Pathology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain., Figols M; Medical Oncology Department, Xarxa Assistencial Universitària de Manresa, Barcelona, Spain., Horneros J; Radiology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain., Pardo JC; Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, 08972, Barcelona, Spain.; Badalona Applied Research Group in Oncology (B-ARGO), Institut Català d'Oncologia - Germans Trias i Pujol Research Institute, Badalona, Barcelona, Spain., Notario L; Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, 08972, Barcelona, Spain.; Badalona Applied Research Group in Oncology (B-ARGO), Institut Català d'Oncologia - Germans Trias i Pujol Research Institute, Badalona, Barcelona, Spain., Ruiz de Porras V; Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, 08972, Barcelona, Spain.; Badalona Applied Research Group in Oncology (B-ARGO), Institut Català d'Oncologia - Germans Trias i Pujol Research Institute, Badalona, Barcelona, Spain., Perez I; Medical Oncology Department, Xarxa Assistencial Universitària de Manresa, Barcelona, Spain., Areal J; Urology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain., Esteve A; Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, 08972, Barcelona, Spain.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2022 Nov; Vol. 40 (11), pp. 2627-2634. Date of Electronic Publication: 2022 Sep 15.
DOI: 10.1007/s00345-022-04147-4
Abstrakt: Purpose: To develop a risk score based on a prognostic model and a nomogram integrating baseline clinicopathological variables to predict bladder cancer-specific survival (BCSS) to neoadjuvant chemotherapy (NAC) in muscle-invasive bladder cancer (MIBC) patients.
Methods: We retrospectively identified a consecutive sample of 247 MIBC patients treated with cisplatin-based NAC-plus-cystectomy in two Spanish hospitals between 2000 and 2019. Age at MIBC diagnosis, sex, histology, lymphovascular invasion, previous non-MIBC, hydronephrosis, and clinical TNM were included in the initial Cox regression model. A risk score was computed based on the final prognostic model and a nomogram was used to estimate BCSS at 2 and 5 years.
Results: Median age was 66 years; 89% were males; 83% had pure urothelial carcinoma; 16.2% had previous non-MIBC. Clinical stage was T2N0, T3-4aN0, and Tx-4N + in 24%, 57%, and 19% of patients, respectively. Complete pathological response was seen in 29.4% and downstaging to non-MIBC (ypT1, ypTa, ypTis) in 12.5% of patients. Overall 5-year BCSS was 59%. Four prognostic factors were identified: variant histology, previous non-MIBC, female sex and hydronephrosis. By adding the points attributed to each of these factors, we categorized patients in three groups: low-risk (0 points); intermediate-risk (1-9 points); high-risk (≥ 10 points). Five-year BCSS was 72%, 53%, and 15%, respectively (p < 0.0001).
Conclusion: We developed a nomogram and risk score based on four baseline clinicopathological characteristics to predict BCSS to NAC-plus-cystectomy in MIBC patients. If validated in prospective studies, this nomogram can be useful for selecting patients likely to benefit from NAC.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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