Nomogram for Predicting Risk of Cystectomy or Recurrence after Bladder Preserving Trimodality Therapy for Muscle Invasive Bladder Cancer

Abstract

Materials/Methods: From 1986 to 2009, 314 patients were managed with selective bladder preservation at MGH. Treatment consisted of maximal transurethral resection of bladder tumor (TURBT) followed by split course chemoradiation. Patients with a complete response at midtreatment cystoscopic assessment completed radiation, while those with a lesser response underwent a prompt cystectomy. For this analysis, BI-DFS was defined as the absence of local invasive or regional recurrence, distant metastasis, bladder cancer related death or radical cystectomy. ACox proportional hazards model was constructed using 7 clinical and treatment variables to build a prognostic nomogram estimating 5 and 10-year BI-DFS. Backward selection was employed such that only variables maintaining a p value of 0.2 or less were retained in the final model.