PD35-06 POST-OPERATIVE NOMOGRAM TO PREDICT CANCER-SPECIFIC SURVIVAL AFTER RADICAL NEPHROURETERECTOMY IN PATIENTS WITH PT1-T3 N0/NX UPPER TRACT UROTHELIAL CARCINOMA WITHOUT METASTASIS

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Tumors I1 Apr 2014PD35-06 POST-OPERATIVE NOMOGRAM TO PREDICT CANCER-SPECIFIC SURVIVAL AFTER RADICAL NEPHROURETERECTOMY IN PATIENTS WITH PT1-T3 N0/NX UPPER TRACT UROTHELIAL CARCINOMA WITHOUT METASTASIS Thomas Seisen, Pierre Colin, VIncent Hupertan, David Yates, Evanguelos Xylinas, Laurent Nison, Olivier Cussenot, Alxandre De La Taille, Yann Neuzillet, Karim Bensalah, Giacomo Novara, Francesco Montorsi, Richard Ziguener, Mesut Remzi, Jay Raman, Shahrokh Shariat, and Morgan Rouprêt Thomas SeisenThomas Seisen More articles by this author , Pierre ColinPierre Colin More articles by this author , VIncent HupertanVIncent Hupertan More articles by this author , David YatesDavid Yates More articles by this author , Evanguelos XylinasEvanguelos Xylinas More articles by this author , Laurent NisonLaurent Nison More articles by this author , Olivier CussenotOlivier Cussenot More articles by this author , Alxandre De La TailleAlxandre De La Taille More articles by this author , Yann NeuzilletYann Neuzillet More articles by this author , Karim BensalahKarim Bensalah More articles by this author , Giacomo NovaraGiacomo Novara More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Richard ZiguenerRichard Ziguener More articles by this author , Mesut RemziMesut Remzi More articles by this author , Jay RamanJay Raman More articles by this author , Shahrokh ShariatShahrokh Shariat More articles by this author , and Morgan RouprêtMorgan Rouprêt More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2419AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To propose and validate a nomogram to predict cancer specific survival (CSS) after radical nephroureterectomy (RNU) in patients with pT1-3/N0-x upper tract urothelial carcinoma (UTUC). METHODS The international and the French national collaborative groups on UTUC pooled data on 3387 patients treated with RNU. Only 2233 pT1-3/N0-x patients naïve from chemotherapy were included in the current study. Population was randomly split into the development cohort (1563) and external validation cohort (670). To build the nomogram, logistic regressions were used for univariable and multivariable analyses. Different models were generated. The most accurate model was assessed using Harrell’s concordance index (c-index) and decision curve analysis (DCA). Internal validation was then performed by bootstrapping. Finally, the nomogram was calibrated and externally validated in the external dataset. RESULTS Out of 1563 patients in the nomogram development cohort, 309 (19.7%) died during follow-up as a consequence of UTUC. The actuarial CSS probability at 5 years was 75.7% (95% CI, 73.2-78.6). DCA revealed that the use of the best model was associated with benefit gains relative to prediction of CSS. The optimized nomogram included only six variables associated with CSS in multivariable analysis (Fig A): age (p<0.001), pT stage (p<0.001), grade (p=0.02), location (p<0.001), architecture (p=0.001) and LVI (p=0.001). The nomogram’s accuracy was 0.81 (95% CI, 0.78-0.85). Limitations included the retrospective study design and lack of a central pathological review. CONCLUSIONS An accurate post-operative nomogram was developed for predicting CSS post RNU only in locally and/or locally advanced UTUC without metastatis where the decision of an adjuvant treatment is controversial but crucial for the oncologic outcome. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e892-e893 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Thomas Seisen More articles by this author Pierre Colin More articles by this author VIncent Hupertan More articles by this author David Yates More articles by this author Evanguelos Xylinas More articles by this author Laurent Nison More articles by this author Olivier Cussenot More articles by this author Alxandre De La Taille More articles by this author Yann Neuzillet More articles by this author Karim Bensalah More articles by this author Giacomo Novara More articles by this author Francesco Montorsi More articles by this author Richard Ziguener More articles by this author Mesut Remzi More articles by this author Jay Raman More articles by this author Shahrokh Shariat More articles by this author Morgan Rouprêt More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...