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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 |
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| container_end_page | 3741 |
| container_issue | 11 |
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| container_title | Cancer medicine (Malden, MA) |
| container_volume | 9 |
| creator | 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 |
| description | 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 |
| doi_str_mv | 10.1002/cam4.2988 |
| format | article |
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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 < .001), chronic kidney disease (HR, 1.56; P = .032), tumor location (HR, 1.60; P = .029), hydronephrosis (HR, 2.71; P < .001), and local invasion on imaging (HR, 8.59; P < .001) were independent predictive factors. After bootstrapping, a well‐calibrated nomogram achieved discriminative accuracy of 0.77 in the development cohort. The decision curve analysis demonstrated improved risk prediction against threshold probabilities (≥8%) of pLAD. These results were consistent in the validation cohort.
Conclusion
Our novel nomogram allows for more highly accurate prediction of pLAD of UTUC. This nomogram integrates standard imaging and laboratory factors that help to identify patients who will benefit from preoperative chemotherapy, extended lymph node dissection, or both.
We developed a preoperative nomogram for the prediction of pathological locally advanced disease of clinically localized upper urinary tract carcinoma using five readily available variables based on standard imaging and laboratory findings. The use of our model will improve clinical decision‐making with regard to candidates for neoadjuvant chemotherapy and/or extended lymphnode dissection, even in patients who are omitted from ureteroscopy or who have insignificant tumor on imaging, prior to extirpative surgery for upper urinary tract carcinoma.</description><identifier>ISSN: 2045-7634</identifier><identifier>EISSN: 2045-7634</identifier><identifier>DOI: 10.1002/cam4.2988</identifier><identifier>PMID: 32253820</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>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</subject><ispartof>Cancer medicine (Malden, MA), 2020-06, Vol.9 (11), p.3733-3741</ispartof><rights>2020 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.</rights><rights>2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6198-780d244fb923cc0be977a27e1ac48b4b9208948df5985d0c5934d4198775e1473</citedby><cites>FETCH-LOGICAL-c6198-780d244fb923cc0be977a27e1ac48b4b9208948df5985d0c5934d4198775e1473</cites><orcidid>0000-0001-9503-7356 ; 0000-0003-1119-312X ; 0000-0003-1069-2816</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2411121941/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2411121941?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11561,25752,27923,27924,37011,37012,44589,46051,46475,53790,53792,74997</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32253820$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoshida, Takashi</creatorcontrib><creatorcontrib>Kobayashi, Takashi</creatorcontrib><creatorcontrib>Kawaura, Takayuki</creatorcontrib><creatorcontrib>Miyake, Makito</creatorcontrib><creatorcontrib>Ito, Katsuhiro</creatorcontrib><creatorcontrib>Okuno, Hiroshi</creatorcontrib><creatorcontrib>Murota, Takashi</creatorcontrib><creatorcontrib>Makita, Noriyuki</creatorcontrib><creatorcontrib>Kawakita, Mutsushi</creatorcontrib><creatorcontrib>Kawa, Gen</creatorcontrib><creatorcontrib>Kitawaki, Tomoki</creatorcontrib><creatorcontrib>Fujimoto, Kiyohide</creatorcontrib><creatorcontrib>Matsuyama, Hideyasu</creatorcontrib><creatorcontrib>Shiina, Hiroaki</creatorcontrib><creatorcontrib>Azuma, Haruhito</creatorcontrib><creatorcontrib>Ogawa, Osamu</creatorcontrib><creatorcontrib>Kinoshita, Hidefumi</creatorcontrib><creatorcontrib>Matsuda, Tadashi</creatorcontrib><title>Development and external validation of a preoperative nomogram for predicting pathological locally advanced disease of clinically localized upper urinary tract carcinoma</title><title>Cancer medicine (Malden, MA)</title><addtitle>Cancer Med</addtitle><description>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 < .001), chronic kidney disease (HR, 1.56; P = .032), tumor location (HR, 1.60; P = .029), hydronephrosis (HR, 2.71; P < .001), and local invasion on imaging (HR, 8.59; P < .001) were independent predictive factors. After bootstrapping, a well‐calibrated nomogram achieved discriminative accuracy of 0.77 in the development cohort. The decision curve analysis demonstrated improved risk prediction against threshold probabilities (≥8%) of pLAD. These results were consistent in the validation cohort.
Conclusion
Our novel nomogram allows for more highly accurate prediction of pLAD of UTUC. This nomogram integrates standard imaging and laboratory factors that help to identify patients who will benefit from preoperative chemotherapy, extended lymph node dissection, or both.
We developed a preoperative nomogram for the prediction of pathological locally advanced disease of clinically localized upper urinary tract carcinoma using five readily available variables based on standard imaging and laboratory findings. The use of our model will improve clinical decision‐making with regard to candidates for neoadjuvant chemotherapy and/or extended lymphnode dissection, even in patients who are omitted from ureteroscopy or who have insignificant tumor on imaging, prior to extirpative surgery for upper urinary tract carcinoma.</description><subject>Aged</subject><subject>Anemia</subject><subject>Bladder cancer</subject><subject>Chemotherapy</subject><subject>Clinical Cancer Research</subject><subject>Collaboration</subject><subject>Dissection</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hydronephrosis</subject><subject>Kidney diseases</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Nephrectomy - methods</subject><subject>Neutrophils</subject><subject>nomogram</subject><subject>Nomograms</subject><subject>Oncology</subject><subject>Original Research</subject><subject>Patients</subject><subject>Preoperative Care</subject><subject>Prognosis</subject><subject>renal pelvis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>ROC Curve</subject><subject>Surgery</subject><subject>surgical procedure</subject><subject>Tomography</subject><subject>Tumors</subject><subject>ureter</subject><subject>Urinary tract</subject><subject>Urogenital system</subject><subject>Urologic Neoplasms - pathology</subject><subject>Urologic Neoplasms - surgery</subject><subject>Urothelial carcinoma</subject><subject>Variables</subject><issn>2045-7634</issn><issn>2045-7634</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kkFvFCEUgCdGY5vag3_AkHjRw7bAMAtzMWlWq01qvOiZvIE3WzYMjMzM1vUf-S_L7NamNZEDkPc-Pl7gFcVrRs8YpfzcQCfOeK3Us-KYU1Et5LIUzx_tj4rTYdjQPCTlS8leFkcl51WpOD0u_nzELfrYdxhGAsES_DViCuDJFryzMLoYSGwJkD5h7DHlyBZJiF1cJ-hIG9Ocsc6MLqxJD-NN9HHtTDb4mGe_I2C3EAxaYt2AMODsM94Fd0jvMfc756c-X0Cm5AKkHRkTmJEYSMbl6-BV8aIFP-Dp_XpS_Lj89H31ZXH97fPV6uJ6YZasVgupqOVCtE3NS2Nog7WUwCUyMEI1IoepqoWybVWrylJT1aWwIp-UskImZHlSXB28NsJG98l1uRgdwel9IKa1hjQ641GLBhoJrFk2pRJGcQWtapQQwJBVBiG7Phxc_dR0aE1-5AT-ifRpJrgbvY5bLblaCimy4N29IMWfEw6j7txg0HsIGKdB81JJXtUVm9G3_6CbOM0_mSnBGOOsFixT7w-USXEYErYPxTCq537Scz_puZ8y--Zx9Q_k3-7JwPkBuHUed_836dXFV7FX3gEzcti7</recordid><startdate>202006</startdate><enddate>202006</enddate><creator>Yoshida, Takashi</creator><creator>Kobayashi, Takashi</creator><creator>Kawaura, Takayuki</creator><creator>Miyake, Makito</creator><creator>Ito, Katsuhiro</creator><creator>Okuno, Hiroshi</creator><creator>Murota, Takashi</creator><creator>Makita, Noriyuki</creator><creator>Kawakita, Mutsushi</creator><creator>Kawa, Gen</creator><creator>Kitawaki, Tomoki</creator><creator>Fujimoto, Kiyohide</creator><creator>Matsuyama, Hideyasu</creator><creator>Shiina, Hiroaki</creator><creator>Azuma, Haruhito</creator><creator>Ogawa, Osamu</creator><creator>Kinoshita, Hidefumi</creator><creator>Matsuda, Tadashi</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-9503-7356</orcidid><orcidid>https://orcid.org/0000-0003-1119-312X</orcidid><orcidid>https://orcid.org/0000-0003-1069-2816</orcidid></search><sort><creationdate>202006</creationdate><title>Development and external validation of a preoperative nomogram for predicting pathological locally advanced disease of clinically localized upper urinary tract carcinoma</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6198-780d244fb923cc0be977a27e1ac48b4b9208948df5985d0c5934d4198775e1473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Anemia</topic><topic>Bladder cancer</topic><topic>Chemotherapy</topic><topic>Clinical Cancer Research</topic><topic>Collaboration</topic><topic>Dissection</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hydronephrosis</topic><topic>Kidney diseases</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Nephrectomy - methods</topic><topic>Neutrophils</topic><topic>nomogram</topic><topic>Nomograms</topic><topic>Oncology</topic><topic>Original Research</topic><topic>Patients</topic><topic>Preoperative Care</topic><topic>Prognosis</topic><topic>renal pelvis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>ROC Curve</topic><topic>Surgery</topic><topic>surgical procedure</topic><topic>Tomography</topic><topic>Tumors</topic><topic>ureter</topic><topic>Urinary tract</topic><topic>Urogenital system</topic><topic>Urologic Neoplasms - pathology</topic><topic>Urologic Neoplasms - surgery</topic><topic>Urothelial carcinoma</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoshida, Takashi</creatorcontrib><creatorcontrib>Kobayashi, Takashi</creatorcontrib><creatorcontrib>Kawaura, Takayuki</creatorcontrib><creatorcontrib>Miyake, Makito</creatorcontrib><creatorcontrib>Ito, Katsuhiro</creatorcontrib><creatorcontrib>Okuno, Hiroshi</creatorcontrib><creatorcontrib>Murota, Takashi</creatorcontrib><creatorcontrib>Makita, Noriyuki</creatorcontrib><creatorcontrib>Kawakita, Mutsushi</creatorcontrib><creatorcontrib>Kawa, Gen</creatorcontrib><creatorcontrib>Kitawaki, Tomoki</creatorcontrib><creatorcontrib>Fujimoto, Kiyohide</creatorcontrib><creatorcontrib>Matsuyama, Hideyasu</creatorcontrib><creatorcontrib>Shiina, Hiroaki</creatorcontrib><creatorcontrib>Azuma, Haruhito</creatorcontrib><creatorcontrib>Ogawa, Osamu</creatorcontrib><creatorcontrib>Kinoshita, Hidefumi</creatorcontrib><creatorcontrib>Matsuda, Tadashi</creatorcontrib><collection>Wiley-Blackwell Open Access Collection</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Cancer medicine (Malden, MA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoshida, Takashi</au><au>Kobayashi, Takashi</au><au>Kawaura, Takayuki</au><au>Miyake, Makito</au><au>Ito, Katsuhiro</au><au>Okuno, Hiroshi</au><au>Murota, Takashi</au><au>Makita, Noriyuki</au><au>Kawakita, Mutsushi</au><au>Kawa, Gen</au><au>Kitawaki, Tomoki</au><au>Fujimoto, Kiyohide</au><au>Matsuyama, Hideyasu</au><au>Shiina, Hiroaki</au><au>Azuma, Haruhito</au><au>Ogawa, Osamu</au><au>Kinoshita, Hidefumi</au><au>Matsuda, Tadashi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development and external validation of a preoperative nomogram for predicting pathological locally advanced disease of clinically localized upper urinary tract carcinoma</atitle><jtitle>Cancer medicine (Malden, MA)</jtitle><addtitle>Cancer Med</addtitle><date>2020-06</date><risdate>2020</risdate><volume>9</volume><issue>11</issue><spage>3733</spage><epage>3741</epage><pages>3733-3741</pages><issn>2045-7634</issn><eissn>2045-7634</eissn><abstract>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 < .001), chronic kidney disease (HR, 1.56; P = .032), tumor location (HR, 1.60; P = .029), hydronephrosis (HR, 2.71; P < .001), and local invasion on imaging (HR, 8.59; P < .001) were independent predictive factors. After bootstrapping, a well‐calibrated nomogram achieved discriminative accuracy of 0.77 in the development cohort. The decision curve analysis demonstrated improved risk prediction against threshold probabilities (≥8%) of pLAD. These results were consistent in the validation cohort.
Conclusion
Our novel nomogram allows for more highly accurate prediction of pLAD of UTUC. This nomogram integrates standard imaging and laboratory factors that help to identify patients who will benefit from preoperative chemotherapy, extended lymph node dissection, or both.
We developed a preoperative nomogram for the prediction of pathological locally advanced disease of clinically localized upper urinary tract carcinoma using five readily available variables based on standard imaging and laboratory findings. The use of our model will improve clinical decision‐making with regard to candidates for neoadjuvant chemotherapy and/or extended lymphnode dissection, even in patients who are omitted from ureteroscopy or who have insignificant tumor on imaging, prior to extirpative surgery for upper urinary tract carcinoma.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>32253820</pmid><doi>10.1002/cam4.2988</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-9503-7356</orcidid><orcidid>https://orcid.org/0000-0003-1119-312X</orcidid><orcidid>https://orcid.org/0000-0003-1069-2816</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 2045-7634 |
| ispartof | Cancer medicine (Malden, MA), 2020-06, Vol.9 (11), p.3733-3741 |
| issn | 2045-7634 2045-7634 |
| language | eng |
| recordid | cdi_doaj_primary_oai_doaj_org_article_4bab7a1b6b384c828af8b844a1e15cea |
| source | Wiley-Blackwell Open Access Collection; Publicly Available Content Database; PubMed Central |
| 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 |
| title | Development and external validation of a preoperative nomogram for predicting pathological locally advanced disease of clinically localized upper urinary tract carcinoma |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T15%3A46%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Development%20and%20external%20validation%20of%20a%20preoperative%20nomogram%20for%20predicting%20pathological%20locally%20advanced%20disease%20of%20clinically%20localized%20upper%20urinary%20tract%20carcinoma&rft.jtitle=Cancer%20medicine%20(Malden,%20MA)&rft.au=Yoshida,%20Takashi&rft.date=2020-06&rft.volume=9&rft.issue=11&rft.spage=3733&rft.epage=3741&rft.pages=3733-3741&rft.issn=2045-7634&rft.eissn=2045-7634&rft_id=info:doi/10.1002/cam4.2988&rft_dat=%3Cproquest_doaj_%3E2411121941%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c6198-780d244fb923cc0be977a27e1ac48b4b9208948df5985d0c5934d4198775e1473%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2411121941&rft_id=info:pmid/32253820&rfr_iscdi=true |