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Tytuł:
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Prognostic Model for Predicting Survival in Patients with Disease Recurrence Following Radical Cystectomy.
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Autorzy:
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Kluth LA; Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Department of Urology, University Medical-Center Hamburg-Eppendorf, Hamburg, Germany.
Xylinas E; Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Department of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France.
Rieken M; Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Department of Urology, University Hospital Basel, Basel, Switzerland.
Kent M; Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Ikeda M; Department of Urology, Kitasato University School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan.
Matsumoto K; Department of Urology, Kitasato University School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan.
Hagiwara M; Department of Urology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Kikuchi E; Department of Urology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Bing MT; Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Gupta A; Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Sewell JM; Department of Urology, University of Minnesota School of Medicine, Minneapolis, MN, USA.
Konety BR; Department of Urology, University of Minnesota School of Medicine, Minneapolis, MN, USA.
Todenhöfer T; Department of Urology, University Medical Hospital of Tuebingen, Tuebingen, Germany.
Schwentner C; Department of Urology, University Medical Hospital of Tuebingen, Tuebingen, Germany.
Masson-Lecomte A; Department of Urology, Hôpital Henri Mondor Créteil, Créteil, France.
Vordos D; Department of Urology, Hôpital Henri Mondor Créteil, Créteil, France.
Roghmann F; Department of Urology, Ruhr University Bochum, Marienhospital, Herne, Germany.
Noldus J; Department of Urology, Ruhr University Bochum, Marienhospital, Herne, Germany.
Razmaria AA; Department of Surgery, Section of Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA.
Smith ND; Department of Surgery, Section of Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA.
Comploj E; Department of Urology, General Hospital of Bolzano, Bolzano, Italy.
Pycha A; Department of Urology, General Hospital of Bolzano, Bolzano, Italy.
Rink M; Department of Urology, University Medical-Center Hamburg-Eppendorf, Hamburg, Germany.
Baniel J; Department of Urology, Rabin Medical Center, Petah-Tikva, Israel.
Mano R; Department of Urology, Rabin Medical Center, Petah-Tikva, Israel.
Novara G; Department of Surgical, Oncological and Gastroenterologic Sciences, Urology Clinic, University of Padua, Padua, Italy.
Aziz A; Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany.
Fritsche HM; Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany.
Brisuda A; Department of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University of Praha, Praha, Czech Republic.
Bivalacqua T; Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Gontero P; Department of Urology, Molinette University Hospital, Torino, Italy.
Boorjian SA; Department of Urology, Mayo Medical School and Mayo Clinic, Rochester, MN, USA.
Vickers AJ; Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Shariat SF; Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Division of Medical Oncology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Department of Urology, Medical University of Vienna, Vienna, Austria. Electronic address: .
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Źródło:
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European urology focus [Eur Urol Focus] 2015 Aug; Vol. 1 (1), pp. 75-81. Date of Electronic Publication: 2015 May 28.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Amsterdam : Elsevier B.V., [2015]-
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Contributed Indexing:
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Keywords: Bladder cancer; Disease recurrence; Metastasis; Model; Prognosis; Survival; Transitional cell carcinoma; Urothelial carcinoma of the bladder
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Entry Date(s):
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Date Created: 20170721 Latest Revision: 20220311
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Update Code:
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20240104
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DOI:
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10.1016/j.euf.2014.10.003
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PMID:
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28723361
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Background: Although the natural history of urothelial carcinoma of the bladder (UCB) from radical cystectomy (RC) to disease recurrence (DR) has been investigated intensively, the course of patients who have experienced DR after RC for UCB remains poorly understood.
Objective: To evaluate the prognostic value of the Bajorin criteria that consists of two risk factors: Karnofsky performance status (KPS) and the presence of visceral metastases (VMs) in patients with DR after RC for UCB. Furthermore, to identify additional factors associated with cancer-specific mortality (CSM) and thus build a multivariable model to predict survival after DR.
Design, Setting, and Participants: We identified 967 patients with UCB who underwent RC at 17 centers between 1979 and 2012 and experienced DR. Of these, 372 patients had complete data we used for analysis.
Outcomes Measurements and Statistical Analysis: Univariable Cox regressions analysis was performed. We used a forward stepwise selection process for our final multivariable model.
Results and Limitations: Within a median follow-up of 18 mo, 266 patients died of disease. Cancer-specific survival at 1 yr was 79%, 76%, and 47% for patients with no (n=105), one (n=180), and two (n=87) risk factors (p<0.001; c-index: 0.604). On multivariable analyses, we found that KPS <80%, higher American Society of Anesthesiologists score, anemia, leukocytosis, and shorter time to DR (all p values <0.034) were independently associated with increased CSM. The combination of time to DR and KPS resulted in improved discrimination (c-index: 0.694).
Conclusions: We confirmed the prognostic value of KPS and VMs in patients with DR following RC for UCB. We also found several other clinical variables to be associated with worse CSM. We developed a model for predicting survival after DR inclusive of time to DR and KPS assessed at DR. If validated, this model could help clinical trial design.
Patient Summary: We developed a model to predict survival following disease recurrence after radical cystectomy for urothelial carcinoma of the bladder, based on time to disease recurrence and Karnofsky performance status.
(Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
