Faculty Collaboration Database

A nomogram predicting the cancer-specific mortality in patients eligible for radical cystectomy evaluating clinical data and neoadjuvant cisplatinum-based chemotherapy. World J Urol 2016 Feb;34(2):207-13

Date

07/23/2015

Pubmed ID

26198750

DOI

10.1007/s00345-015-1640-2

Scopus ID

2-s2.0-84956635875 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

PURPOSE: Despite the increasing number of studies confirming the importance of neoadjuvant chemotherapy (NC) in patients before radical cystectomy (RC) for bladder cancer (BCa), NC remains underused. The aim of our study was to develop a nomogram predicting the cancer-specific mortality (CSM) of patients who underwent RC for transitional BCa, evaluating the available clinical information and the NC.

MATERIALS AND METHODS: We identified 423 patients who underwent RC and pelvic lymph node dissection, treated or not with NC, in two European high-volume centers between 2007 and 2013. Chi-square and Student's t tests were used to evaluate differences between groups. Kaplan-Meier curves were used to assess time to cancer-specific (CSS) and overall survival (OS). Uni- (UVA) and multivariable (MVA) Cox regression analyses were developed to address predictors of CSS and OS. A nomogram based on the Cox regression coefficient was developed to show the impact of NC on CSM.

RESULTS: Mean follow-up was 20.3 months. Our population had mainly pT2 disease (77.1%), and 19.4% had preoperative cisplatinum-based NC. NC showed better CSS at UVA (p = 0.014) and MVA (odds ratio: 0.44; p = 0.043). Overall, the 3-year OS and the CSS rate were 69.3 and 79%, respectively. The nomogram developed to predict the 36-month CSM showed predictive accuracy of 67%.

CONCLUSIONS: We developed the first nomogram predicting the 36-month CSM rate in patients with high-risk BCa according to the clinical data. Moreover, we demonstrate that preoperative cisplatinum-based chemotherapy is associated with better CSS.

Author List

Di Trapani E, Sanchez-Salas R, Gandaglia G, Rocchini L, Moschini M, Lizee D, Carneiro A, Sivaraman A, Barret E, Rozet F, Galiano M, Bennamoun M, Colombo R, Suardi N, Briganti A, Montorsi F, Cathelineau X

Author

Arjun Sivaraman MD Associate Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Carcinoma, Transitional Cell
Cisplatin
Cystectomy
Disease-Free Survival
Female
Follow-Up Studies
France
Humans
Italy
Male
Neoadjuvant Therapy
Nomograms
Odds Ratio
Retrospective Studies
Survival Rate
Time Factors
Treatment Outcome
Urinary Bladder Neoplasms