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International Journal of Clinical Oncology

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01-10-2018 | Original Article

Development and external validation of a nomogram to predict high-grade papillary bladder cancer before first-time transurethral resection of the bladder tumor

Authors: Ken Wakai, Takanobu Utsumi, Kei Yoneda, Ryo Oka, Takumi Endo, Masashi Yano, Masaaki Fujimura, Naoto Kamiya, Nobuyuki Sekita, Kazuo Mikami, Isamu Sugano, Nobuyuki Hiruta, Hiroyoshi Suzuki

Published in: International Journal of Clinical Oncology | Issue 5/2018

Abstract

Background

The aim of this study was to identify the clinical predictors related to the risk of high-grade papillary bladder cancer before first-time transurethral resection of a bladder tumor (TUR-Bt), and to develop and validate a nomogram predicting the risk of high-grade papillary bladder cancer.

Methods

A retrospective clinical study of consecutive patients who underwent first-time TUR-Bt for papillary bladder cancer was performed. Medical records were reviewed uniformly, and the following data were collected: age, sex, episodes of urinary symptoms, tumor size, number of tumors, location of the largest tumor (lateral walls, base, posterior wall, dome, and anterior wall), tumor appearance (papillary or non-papillary, pedunculated or sessile), and urinary cytology. Data from 254 patients (Group A) were used for the development of a nomogram, while data from 170 patients (Group B) were used for its external validation.

Results

High-grade papillary bladder cancer was pathologically diagnosed in 51.6 and 74.6% of Group A and Group B patients, respectively. Based on univariable analyses in Group A, macrohematuria, tumor size, multiple tumors, appearance, and positive urinary cytology were selected as variables to incorporate into a nomogram. The AUC value was 0.81 for the internal validation (Group A), and 0.78 for the external validation (Group B). This novel nomogram can predict high-grade papillary bladder cancer accurately.

Conclusions

The present nomogram can help clinicians calculate the probability in patients with bladder cancer before TUR-Bt and decide on earlier intervention and priorities for the treatment of patients diagnosed with bladder cancer.

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Title: Development and external validation of a nomogram to predict high-grade papillary bladder cancer before first-time transurethral resection of the bladder tumor
Authors: Ken Wakai
Takanobu Utsumi
Kei Yoneda
Ryo Oka
Takumi Endo
Masashi Yano
Masaaki Fujimura
Naoto Kamiya
Nobuyuki Sekita
Kazuo Mikami
Isamu Sugano
Nobuyuki Hiruta
Hiroyoshi Suzuki
Publication date: 01-10-2018
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 5/2018
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-018-1299-y

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Abstract

Background

Methods

Results

Conclusions

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