Development and Validation of a Model for Predicting Intravesical Recurrence in Organ-confined Upper Urinary Tract Urothelial Carcinoma Patients after Radical Nephroureterectomy: a Retrospective Study in One Center with Long-term Follow-up
Although radical nephroureterectomy is the standard treatment method for upper urinary tract urothelial carcinoma, it is associated with a high risk of intravesical recurrence. There are no models for predicting IVR after RNU in patients with organ-confined UTUC. Therefore, we developed and validate...
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Veröffentlicht in: | Pathology oncology research 2020-07, Vol.26 (3), p.1741-1748 |
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description | Although radical nephroureterectomy is the standard treatment method for upper urinary tract urothelial carcinoma, it is associated with a high risk of intravesical recurrence. There are no models for predicting IVR after RNU in patients with organ-confined UTUC. Therefore, we developed and validated a model for postoperative prediction of IVR after RNU. The development cohort consisted of 416 patients who underwent RNU with bladder cuff excision at our center between 1 January 2007 and 31 December 2015. Patient clinicopathologic data were recorded. Multivariate Cox proportional hazard ratio regression was used to build a predictive model with regression coefficients, backward step-wise selection was applied, and the likelihood ratio test with Akaike’s information criterion was used as the stopping rule. An independent cohort consisting of 152 consecutive patients from 1 January 2016 and 31 December 2017 was used for validation. The performance of this predictive model was assessed with respect to discrimination, calibration, and clinical usefulness. The predictors in this model included tumor stage, tumor diameter, tumor location, and tumor grade. In the validation cohort, the model showed good discrimination, with a concordance index of 0.689 (95% CI, 0.629 to 0.748) and good calibration. Decision curve analysis demonstrated that the model was also clinically useful. This study presents a good model that may facilitate individualized postoperative prediction of IVR after RNU in patients with organ-confined UTUC, and thus, may help improve postoperative strategies and facilitate treatment outcomes. |
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There are no models for predicting IVR after RNU in patients with organ-confined UTUC. Therefore, we developed and validated a model for postoperative prediction of IVR after RNU. The development cohort consisted of 416 patients who underwent RNU with bladder cuff excision at our center between 1 January 2007 and 31 December 2015. Patient clinicopathologic data were recorded. Multivariate Cox proportional hazard ratio regression was used to build a predictive model with regression coefficients, backward step-wise selection was applied, and the likelihood ratio test with Akaike’s information criterion was used as the stopping rule. An independent cohort consisting of 152 consecutive patients from 1 January 2016 and 31 December 2017 was used for validation. The performance of this predictive model was assessed with respect to discrimination, calibration, and clinical usefulness. The predictors in this model included tumor stage, tumor diameter, tumor location, and tumor grade. In the validation cohort, the model showed good discrimination, with a concordance index of 0.689 (95% CI, 0.629 to 0.748) and good calibration. Decision curve analysis demonstrated that the model was also clinically useful. This study presents a good model that may facilitate individualized postoperative prediction of IVR after RNU in patients with organ-confined UTUC, and thus, may help improve postoperative strategies and facilitate treatment outcomes.</description><identifier>ISSN: 1219-4956</identifier><identifier>EISSN: 1532-2807</identifier><identifier>DOI: 10.1007/s12253-019-00748-4</identifier><identifier>PMID: 31643022</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Biomedical and Life Sciences ; Biomedicine ; Bladder cancer ; Cancer Research ; Carcinoma, Transitional Cell - pathology ; Carcinoma, Transitional Cell - surgery ; Humans ; Immunology ; Neoplasm Recurrence, Local - epidemiology ; Nephroureterectomy - methods ; Oncology ; Original Article ; Pathology ; Patients ; Prediction models ; Retrospective Studies ; Urinary tract ; Urogenital system ; Urologic Neoplasms - pathology ; Urologic Neoplasms - surgery ; Urothelial carcinoma</subject><ispartof>Pathology oncology research, 2020-07, Vol.26 (3), p.1741-1748</ispartof><rights>Arányi Lajos Foundation 2019</rights><rights>Arányi Lajos Foundation 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-95196f00866a86c453f424a361d4036404ecf02a6b8f071d7ce244048ab4aebd3</citedby><cites>FETCH-LOGICAL-c375t-95196f00866a86c453f424a361d4036404ecf02a6b8f071d7ce244048ab4aebd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12253-019-00748-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12253-019-00748-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27926,27927,41490,42559,51321</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31643022$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Xuanyu</creatorcontrib><creatorcontrib>Bu, Renge</creatorcontrib><creatorcontrib>Liu, Zeqi</creatorcontrib><creatorcontrib>Wu, Bin</creatorcontrib><creatorcontrib>Bai, Song</creatorcontrib><title>Development and Validation of a Model for Predicting Intravesical Recurrence in Organ-confined Upper Urinary Tract Urothelial Carcinoma Patients after Radical Nephroureterectomy: a Retrospective Study in One Center with Long-term Follow-up</title><title>Pathology oncology research</title><addtitle>Pathol. Oncol. Res</addtitle><addtitle>Pathol Oncol Res</addtitle><description>Although radical nephroureterectomy is the standard treatment method for upper urinary tract urothelial carcinoma, it is associated with a high risk of intravesical recurrence. There are no models for predicting IVR after RNU in patients with organ-confined UTUC. Therefore, we developed and validated a model for postoperative prediction of IVR after RNU. The development cohort consisted of 416 patients who underwent RNU with bladder cuff excision at our center between 1 January 2007 and 31 December 2015. Patient clinicopathologic data were recorded. Multivariate Cox proportional hazard ratio regression was used to build a predictive model with regression coefficients, backward step-wise selection was applied, and the likelihood ratio test with Akaike’s information criterion was used as the stopping rule. An independent cohort consisting of 152 consecutive patients from 1 January 2016 and 31 December 2017 was used for validation. The performance of this predictive model was assessed with respect to discrimination, calibration, and clinical usefulness. The predictors in this model included tumor stage, tumor diameter, tumor location, and tumor grade. In the validation cohort, the model showed good discrimination, with a concordance index of 0.689 (95% CI, 0.629 to 0.748) and good calibration. Decision curve analysis demonstrated that the model was also clinically useful. This study presents a good model that may facilitate individualized postoperative prediction of IVR after RNU in patients with organ-confined UTUC, and thus, may help improve postoperative strategies and facilitate treatment outcomes.</description><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Bladder cancer</subject><subject>Cancer Research</subject><subject>Carcinoma, Transitional Cell - pathology</subject><subject>Carcinoma, Transitional Cell - surgery</subject><subject>Humans</subject><subject>Immunology</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Nephroureterectomy - methods</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pathology</subject><subject>Patients</subject><subject>Prediction models</subject><subject>Retrospective Studies</subject><subject>Urinary tract</subject><subject>Urogenital system</subject><subject>Urologic Neoplasms - pathology</subject><subject>Urologic Neoplasms - surgery</subject><subject>Urothelial carcinoma</subject><issn>1219-4956</issn><issn>1532-2807</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Uk1v1DAQjRCIlsIf4IAsceES8FechBtaKFRaaLV0uUZee7J1ldjBdrbaX81fYNgtIHHgZM_Me29m7FcUzxl9zSit3yTGeSVKytoSQ9mU8kFxyirBS97Q-iHeOZZkW6mT4klKtxRRqlWPixPBlBSU89Pix3vYwRCmEXwm2lvyTQ_O6uyCJ6EnmnwOFgbSh0iuIlhnsvNbcuFz1DtIzuiBrMDMMYI3QJwnl3GrfWmC750HS9bTBJGso_M67sl11CZjFPINDA65Cx2N82HU5Ap74gyJ6D4jY6XtQfwLTDcxzBEwCSaHcf8Wh1pBjiFNmHA7IF_zbPeH3h7IAkWQf-fyDVkGvy0xGsl5GIZwV87T0-JRr4cEz-7Ps2J9_uF68alcXn68WLxblkbUVS7birWqp7RRSjfKyEr0kkstFLOSCiWpBNNTrtWm6WnNbG2AS8w2eiM1bKw4K14ddacYvs-Qcje6ZGAYtIcwp44L2uBXiZoi9OU_0Ftc2ON0HZdMUs543SKKH1EGN08R-m6KbsRH7RjtftmhO9qhQzt0Bzt0Ekkv7qXnzQj2D-X3_yNAHAEJS34L8W_v_8j-BDP2xIg</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Zhang, Xuanyu</creator><creator>Bu, Renge</creator><creator>Liu, Zeqi</creator><creator>Wu, Bin</creator><creator>Bai, Song</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20200701</creationdate><title>Development and Validation of a Model for Predicting Intravesical Recurrence in Organ-confined Upper Urinary Tract Urothelial Carcinoma Patients after Radical Nephroureterectomy: a Retrospective Study in One Center with Long-term Follow-up</title><author>Zhang, Xuanyu ; Bu, Renge ; Liu, Zeqi ; Wu, Bin ; Bai, Song</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-95196f00866a86c453f424a361d4036404ecf02a6b8f071d7ce244048ab4aebd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Bladder cancer</topic><topic>Cancer Research</topic><topic>Carcinoma, Transitional Cell - pathology</topic><topic>Carcinoma, Transitional Cell - surgery</topic><topic>Humans</topic><topic>Immunology</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Nephroureterectomy - methods</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pathology</topic><topic>Patients</topic><topic>Prediction models</topic><topic>Retrospective Studies</topic><topic>Urinary tract</topic><topic>Urogenital system</topic><topic>Urologic Neoplasms - pathology</topic><topic>Urologic Neoplasms - surgery</topic><topic>Urothelial carcinoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Xuanyu</creatorcontrib><creatorcontrib>Bu, Renge</creatorcontrib><creatorcontrib>Liu, Zeqi</creatorcontrib><creatorcontrib>Wu, Bin</creatorcontrib><creatorcontrib>Bai, Song</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pathology oncology research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Xuanyu</au><au>Bu, Renge</au><au>Liu, Zeqi</au><au>Wu, Bin</au><au>Bai, Song</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development and Validation of a Model for Predicting Intravesical Recurrence in Organ-confined Upper Urinary Tract Urothelial Carcinoma Patients after Radical Nephroureterectomy: a Retrospective Study in One Center with Long-term Follow-up</atitle><jtitle>Pathology oncology research</jtitle><stitle>Pathol. Oncol. Res</stitle><addtitle>Pathol Oncol Res</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>26</volume><issue>3</issue><spage>1741</spage><epage>1748</epage><pages>1741-1748</pages><issn>1219-4956</issn><eissn>1532-2807</eissn><abstract>Although radical nephroureterectomy is the standard treatment method for upper urinary tract urothelial carcinoma, it is associated with a high risk of intravesical recurrence. There are no models for predicting IVR after RNU in patients with organ-confined UTUC. Therefore, we developed and validated a model for postoperative prediction of IVR after RNU. The development cohort consisted of 416 patients who underwent RNU with bladder cuff excision at our center between 1 January 2007 and 31 December 2015. Patient clinicopathologic data were recorded. Multivariate Cox proportional hazard ratio regression was used to build a predictive model with regression coefficients, backward step-wise selection was applied, and the likelihood ratio test with Akaike’s information criterion was used as the stopping rule. An independent cohort consisting of 152 consecutive patients from 1 January 2016 and 31 December 2017 was used for validation. The performance of this predictive model was assessed with respect to discrimination, calibration, and clinical usefulness. The predictors in this model included tumor stage, tumor diameter, tumor location, and tumor grade. In the validation cohort, the model showed good discrimination, with a concordance index of 0.689 (95% CI, 0.629 to 0.748) and good calibration. Decision curve analysis demonstrated that the model was also clinically useful. This study presents a good model that may facilitate individualized postoperative prediction of IVR after RNU in patients with organ-confined UTUC, and thus, may help improve postoperative strategies and facilitate treatment outcomes.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>31643022</pmid><doi>10.1007/s12253-019-00748-4</doi><tpages>8</tpages></addata></record> |
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subjects | Biomedical and Life Sciences Biomedicine Bladder cancer Cancer Research Carcinoma, Transitional Cell - pathology Carcinoma, Transitional Cell - surgery Humans Immunology Neoplasm Recurrence, Local - epidemiology Nephroureterectomy - methods Oncology Original Article Pathology Patients Prediction models Retrospective Studies Urinary tract Urogenital system Urologic Neoplasms - pathology Urologic Neoplasms - surgery Urothelial carcinoma |
title | Development and Validation of a Model for Predicting Intravesical Recurrence in Organ-confined Upper Urinary Tract Urothelial Carcinoma Patients after Radical Nephroureterectomy: a Retrospective Study in One Center with Long-term Follow-up |
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