Abstract
BackgroundThere are differences in survival between high-and low-grade Upper Tract Urothelial Carcinoma (UTUC). Our study aimed to develop a nomogram to predict overall survival (OS) of patients with high- and low-grade UTUC after tumor resection, and to explore the difference between high- and low-grade patients.MethodsPatients confirmed to have UTUC between 2004 and 2015 were selected from the Surveillance, Epidemiology and End Results (SEER) database. The UTUCs were identified and classified as high- and low-grade, and 1-, 3- and 5-year nomograms were established. The nomogram was then validated using the Chinese multicenter dataset (patients diagnosed in Shandong, China between January 2010 and October 2020).ResultsIn the high-grade UTUC patients, nine important factors related to survival after tumor resection were identified to construct nomogram. The C index of training dataset was 0.740 (95% confidence interval [CI]: 0.727–0.754), showing good calibration. The C index of internal validation dataset was 0.729(95% CI:0.707–0.750). On the other hand, Two independent predictors were identified to construct nomogram of low-grade UTUC. The C index was 0.714 (95% CI: 0.671–0.758) for the training set,0.731(95% CI:0.670–0.791) for the internal validation dataset. Encouragingly, the nomogram was clinically useful and had a good discriminative ability to identify patients at high risk.ConclusionWe constructed a nomogram and a corresponding risk classification system predicting the OS of patients with an initial diagnosis of high-and low-grade UTUC.
Highlights
Upper Tract Urothelial Carcinoma (UTUC) is a relatively rare tumor of the genitourinary system, affecting 2 in every 100,000 people [1]
The criteria for data extraction from the database were: (1) patients diagnosed with UTUC between 2004 and 2015; (2) the only or the first primary tumor confirmed by histology was UTUC,no history of bladder cancer or radical cystectomy;(3) SEER records for which the International Classification of Diseases for Oncology, third edition (ICD-O-3) codes included:“C65.9-Renal pelvis”,“C66.9Ureter”;(4)(ICD-O-3) morphology:8020/3, 8031/38082/ 38120/38122/38130/38131/3;(5) tumor resection was performed; (6) clinicopathological and follow-up data were available
The records were randomly divided into the SEER training dataset and SEER internal validation dataset according to a 7:3 ratio
Summary
Upper Tract Urothelial Carcinoma (UTUC) is a relatively rare tumor of the genitourinary system, affecting 2 in every 100,000 people [1]. It accounts for approximately 5 to 10% of urothelial malignancies [2, 3]. Radical nephroureterectomy (RNU) is the gold standard for the treatment of highrisk patients with UTUC [2, 5]. There are differences in survival between high-and low-grade Upper Tract Urothelial Carcinoma (UTUC). Our study aimed to develop a nomogram to predict overall survival (OS) of patients with high- and lowgrade UTUC after tumor resection, and to explore the difference between high- and low-grade patients
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