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World Journal of Urology
Published in: World Journal of Urology 9/2019

01-09-2019 | Original Article

Novel nomograms to predict recurrence and progression in primary non-muscle-invasive bladder cancer: validation of predictive efficacy in comparison with European Organization of Research and Treatment of Cancer scoring system

Authors: Hyung Suk Kim, Chang Wook Jeong, Cheol Kwak, Hyeon Hoe Kim, Ja Hyeon Ku

Published in: World Journal of Urology | Issue 9/2019

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Abstract

Purpose

To develop and validate novel nomograms to predict recurrence and progression after transurethral resection of bladder tumor (TURBT) in Korean patients with non-muscle-invasive bladder cancer (NMIBC).

Methods

We retrospectively analyzed the clinical data on 970 newly diagnosed NMIBC patients after TURBT between 2000 and 2013 in a single institution. We used multivariate Cox proportional hazard models to identify the significant predictors of recurrence and progression, which resulted in the construction of the nomograms predicting the 5-year probability of recurrence and progression. We internally validated the nomograms using the area under the receiver-operating characteristics’ curves and calibration plots. In addition, the clinical usefulness of each nomogram was assessed and compared with that of the European Organization of Research and Treatment of Cancer (EORTC)-scoring system using decision curve analysis (DCA).

Results

The significant factors related to recurrence were gross hematuria at diagnosis, previous or concomitant upper urinary tract urothelial carcinoma (UTUC), pT1 tumor, high tumor grade, multiple tumors, and intravesical therapy. The significant predictors of progression were previous or concomitant UTUC, pT1 tumor, high tumor grade, carcinoma in situ, and lymphovascular invasion. The 5-year predictive accuracy of each nomogram was 65% for recurrence and 70% for progression, respectively. Compared with the EORTC-scoring system, the nomograms were generally well calibrated. On DCA, each nomogram presented better net benefit gains than did the EORTC-scoring system across a wide range of threshold probabilities.

Conclusions

Our novel nomograms are not completely accurate, but they show a reasonable level of discriminative ability, adequate calibration, and meaningful net benefit gain for the prediction of recurrence and progression after TURBT in Korean NMIBC patients. Additional external validation will be required to generalize the nomograms which we developed.
Literature
1.
2.
Babjuk M, Böhle A, Burger M et al (2017) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol 71:447–461CrossRefPubMed
3.
Chang SS, Boorjian SA, Chou R et al (2016) Diagnosis and treatment of non-muscle invasive bladder cancer: AUA/SUO Guideline. J Urol 22:1086–1094
4.
Mansoor M, Ali S, Fasihuddin Q, Baloch MU (2011) Superficial bladder tumours: recurrence and progression. J Coll Physicians Surg Pak 21:157–160PubMed
5.
Kiemeney LA, Witjes JA, Heijbroek RP, Verbeek AL, Debruyne FM (1993) Predictability of recurrent and progressive disease in individual patients with primary superficial bladder cancer. J Urol 150:60–64CrossRefPubMed
6.
Millan-Rodriguez F, Chechile-Toniolo G, Salvador-Bayarri J et al (2000) Primary superficial bladder cancer risk groups according to progression, mortality and recurrence. J Urol 164:680–684CrossRefPubMed
7.
Nguyen CT, Stephenson AJ, Kattan MW (2010) Are nomograms needed in the management of bladder cancer? Urol Oncol 28:102–107CrossRefPubMed
8.
Sylvester RJ, van der Meijden AP, Oosterlinck W et al (2006) Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 49:466–477CrossRefPubMed
9.
Hong SJ, Cho KS, Han M et al (2008) Nomograms for prediction of disease recurrence in patients with primary Ta, T1 transitional cell carcinoma of the bladder. J Korean Med Sci 23:428–433CrossRefPubMedPubMedCentral
10.
Fernandez-Gomez J, Madero R, Solsona E et al (2009) Predicting nonmuscle invasive bladder cancer recurrence and progression in patients treated with bacillus Calmette–Guerin: the CUETO scoring model. J Urol 182:2195–2203CrossRefPubMed
11.
Pan CC, Chang YH, Chen KK et al (2010) Constructing prognostic model incorporating the 2004 WHO/ISUP classification for patients with non-muscle-invasive urothelial tumours of the urinary bladder. J Clin Pathol 63:910–915CrossRefPubMed
12.
Ali-El-Dein B, Sooriakumaran P, Trinh QD et al (2013) Construction of predictive models for recurrence and progression in > 1000 patients with non-muscle-invasive bladder cancer (NMIBC) from a single centre. BJU Int 111:E331–E341CrossRefPubMed
13.
Ieda T, Muto S, Shimizu F et al (2016) Development and validation of a novel recurrence risk stratification for initial non-muscle invasive bladder cancer in Asia. EBioMedicine 12:98–104CrossRefPubMedPubMedCentral
14.
Lammers RJ, Hendriks JC, Rodriguez Faba OR et al (2016) Prediction model for recurrence probabilities after intravesical chemotherapy in patients with intermediate-risk non-muscle-invasive bladder cancer, including external validation. World J Urol 34:173–180CrossRefPubMed
15.
Seo KW, Kim BH, Park CH, Kim CI, Chang HS (2010) The efficacy of the EORTC scoring system and risk tables for the prediction of recurrence and progression of non-muscle-invasive bladder cancer after intravesical bacillus Calmette–Guerin instillation. Korean J Urol 51:165–170CrossRefPubMedPubMedCentral
16.
Ding W, Chen Z, Gou Y et al (2014) Are EORTC risk tables suitable for Chinese patients with non-muscle-invasive bladder cancer? Cancer Epidemiol 38:157–161CrossRefPubMed
17.
Kohjimoto Y, Kusumoto H, Nishizawa S et al (2014) External validation of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment scoring models to predict recurrence and progression in Japanese patients with non-muscle invasive bladder cancer treated with bacillus Calmette–Guerin. Int J Urol 21:1201–1207CrossRefPubMed
18.
Heagerty PJ, Lumley T, Pepe MS (2000) Time-dependent ROC curves for censored survival data and a diagnostic marker. Biometrics 56:337–344CrossRefPubMed
19.
DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845CrossRefPubMed
20.
Miller ME, Langefeld CD, Tierney WM, Hui SL, McDonald CJ (1993) Validation of probabilistic predictions. Med Decis Mak 13:49–58CrossRef
21.
Vickers AJ, Elkin EB (2006) Decision curve analysis: a novel method for evaluating prediction models. Med Decis Mak 26:565–574CrossRef
22.
Vickers AJ, Cronin AM, Elkin EB, Gonen M (2008) Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers. BMC Med Inform Decis Mak 8:53CrossRefPubMedPubMedCentral
23.
Kim HS, Kim M, Jeong CW et al (2014) Presence of lymphovascular invasion in urothelial bladder cancer specimens after transurethral resections correlates with risk of upstaging and survival: a systematic review and meta-analysis. Urol Oncol 32:1191–1199CrossRefPubMed
24.
Kim HS, Ku JH, Kim SJ et al (2016) Prognostic factors for recurrence and progression in Korean non-muscle-invasive bladder cancer patients: a retrospective, multi-institutional study. Yonsei Med J 57:855–864CrossRefPubMedPubMedCentral
25.
Sfakianos JP, Kim PH, Hakimi AA, Herr HW (2014) The effect of restaging transurethral resection on recurrence and progression rates in patients with nonmuscle invasive bladder cancer treated with intravesical bacillus Calmette–Guérin. J Urol 191:341–345CrossRefPubMed
26.
Shindo T, Masumori N, Kitamura H et al (2014) Clinical significance of definite muscle layer in TUR specimen for evaluating progression rate in T1G3 bladder cancer: multicenter retrospective study by the Sapporo Medical University Urologic Oncology Consortium (SUOC). World J Urol 32:1281–1285CrossRefPubMed
27.
Fang D, Zhang L, Li X et al (2015) Presence of concomitant non-muscle-invasive bladder cancer in Chinese patients with upper tract urothelial carcinoma: risk factors, characteristics, and predictive Value. Ann Surg Oncol 22:2789–2798CrossRefPubMed
28.
Kim BW, Ha YS, Lee JN et al (2015) Effects of previous or synchronous non-muscle invasive bladder cancer on clinical results after radical nephroureterectomy for upper tract urothelial carcinoma: a multi-institutional study. Urol J 12:2233–2239PubMed
Metadata
Title
Novel nomograms to predict recurrence and progression in primary non-muscle-invasive bladder cancer: validation of predictive efficacy in comparison with European Organization of Research and Treatment of Cancer scoring system
Authors
Hyung Suk Kim
Chang Wook Jeong
Cheol Kwak
Hyeon Hoe Kim
Ja Hyeon Ku
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 9/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2581-3

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