Development and validation of a prognostic nomogram for predicting cancer‐specific survival after radical cystectomy in patients with bladder cancer:A population‐based study. (16th October 2020)

• Record Type: Journal Article
• Authors: Yang, Zhiqiang; Bai, Yunjin; Liu, Maoying; Hu, Xu; Han, Ping
• Is Part Of: Cancer medicine. Volume 9:Number 24(2020)
• Page Start: 9303
• Page End: 9314
• Publication Date: 2020-10-16
• Subjects: bladder cancer -- nomogram -- prognosis -- radical cystectomy -- SEER database; 616.994005
• DOI: 10.1002/cam4.3535
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Purpose: To establish a prognostic model to estimate the cancer‐specific survival (CSS) for urothelial carcinoma of bladder (UCB) patients after radical cystectomy (RC). Methods: A total of 8650 candidates (2004–2011) obtained from the Surveillance, Epidemiology, and End Results (SEER) database were randomly split into development cohort ( n = 4323) and validation cohort ( n = 4327). We performed Cox regression analysis to identify prognostic factors and Kaplan‐Meier analysis to assess survival outcome. A nomogram predicting CSS was constructed. Its performance was validated by calibration curves, the receiver operating characteristic (ROC) curves, concordance index (C‐index), decision curve analysis (DCA), the net reclassification improvement (NRI), and the integrated discrimination improvement (IDI). Results: The nomogram incorporated marital status, T stage, N stage, tumor size, and chemotherapy. In validation cohort, C‐index of the nomogram was 0.707. AUC of the nomogram and AJCC stage were 0.767 versus 0.674. Calibration plots for 3‐ and 5‐year CSS displayed good concordance. DCA curves of the nomogram exhibited larger benefits than the AJCC stage. The NRI and IDI indicated the nomogram outperformed AJCC stage. Conclusions: We have established a prognostic nomogram with improved discriminative ability and clinical benefits for UCB patients after RC. The nomogram alongside an easy access web tool may assist clinicians in optimizing the postoperative management. Abstract : This population‐based study has established a nomogram and its derived webserver to predict cancer‐specific survival probabilities for patients with urothelial carcinoma of the bladder after radical cystectomy. The model's discriminative abilities, accuracy and clinical benefits were validated and performed better than traditional AJCC stage.