Development and external validation of a preoperative nomogram for predicting pathological locally advanced disease of clinically localized upper urinary tract carcinoma

Objective To develop and validate a preoperative nomogram to predict pathological locally advanced disease (pLAD) of clinically localized upper urinary tract urothelial carcinoma (UTUC) treated with extirpative surgery. Methods In total, 1101 patients with cN0M0 UTUC (development cohort, n = 604; va...

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Published in:Cancer medicine (Malden, MA) MA), 2020-06, Vol.9 (11), p.3733-3741
Main Authors: Yoshida, Takashi, Kobayashi, Takashi, Kawaura, Takayuki, Miyake, Makito, Ito, Katsuhiro, Okuno, Hiroshi, Murota, Takashi, Makita, Noriyuki, Kawakita, Mutsushi, Kawa, Gen, Kitawaki, Tomoki, Fujimoto, Kiyohide, Matsuyama, Hideyasu, Shiina, Hiroaki, Azuma, Haruhito, Ogawa, Osamu, Kinoshita, Hidefumi, Matsuda, Tadashi
Format: Article
Language:English
Subjects:
Aged
Anemia
Bladder cancer
Chemotherapy
Clinical Cancer Research
Collaboration
Dissection
Female
Follow-Up Studies
Hemoglobin
Humans
Hydronephrosis
Kidney diseases
Lymph nodes
Lymphatic system
Lymphocytes
Male
Nephrectomy - methods
Neutrophils
nomogram
Nomograms
Oncology
Original Research
Patients
Preoperative Care
Prognosis
renal pelvis
Retrospective Studies
Risk Factors
ROC Curve
Surgery
surgical procedure
Tomography
Tumors
ureter
Urinary tract
Urogenital system
Urologic Neoplasms - pathology
Urologic Neoplasms - surgery
Urothelial carcinoma
Variables
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Summary:Objective To develop and validate a preoperative nomogram to predict pathological locally advanced disease (pLAD) of clinically localized upper urinary tract urothelial carcinoma (UTUC) treated with extirpative surgery. Methods In total, 1101 patients with cN0M0 UTUC (development cohort, n = 604; validation cohort, n = 497) from 2 independent academic databases were retrospectively analyzed. pLAD was defined as pT3/4 and/or pN+. Multivariate logistic regression was used to develop a nomogram. The accuracy of the nomogram was evaluated with a receiver operating characteristic curve, calibration plot, and decision curve analysis. Results The development and validation cohorts comprised 204 (33.8%) and 178 (35.8%) patients with pLAD, respectively. The multivariate analyses showed that the neutrophil‐to‐lymphocyte ratio (hazard ratio [HR], 2.27; P 
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.2988