Nomogram based on baseline clinicopathological characteristics for predicting bladder cancer-specific survival to neoadjuvant chemotherapy in muscle-invasive bladder cancer

Purpose To develop a risk score based on a prognostic model and a nomogram integrating baseline clinicopathological variables to predict bladder cancer-specific survival (BCSS) to neoadjuvant chemotherapy (NAC) in muscle-invasive bladder cancer (MIBC) patients. Methods We retrospectively identified...

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Bibliographic Details
Published in:World journal of urology 2022-11, Vol.40 (11), p.2627-2634
Main Authors: Font, Albert, Domenech, Montserrat, Buisan, Oscar, Lopez, Hector, González, Andrea, Etxaniz, Olatz, Matas, Marta, Elias, Xavier, Gomez, Maica, Figols, Mariona, Horneros, Judith, Pardo, Juan Carlos, Notario, Lucia, Ruiz de Porras, Vicenç, Perez, Ignacio, Areal, Joan, Esteve, Anna
Format: Article
Language:English
Subjects:
Bladder cancer
Chemotherapy
Cisplatin
Histology
Hydronephrosis
Invasiveness
Medical prognosis
Medicine
Medicine & Public Health
Nephrology
Nomograms
Oncology
Original Article
Patients
Survival
Urology
Urothelial carcinoma
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Summary:Purpose To develop a risk score based on a prognostic model and a nomogram integrating baseline clinicopathological variables to predict bladder cancer-specific survival (BCSS) to neoadjuvant chemotherapy (NAC) in muscle-invasive bladder cancer (MIBC) patients. Methods We retrospectively identified a consecutive sample of 247 MIBC patients treated with cisplatin-based NAC-plus-cystectomy in two Spanish hospitals between 2000 and 2019. Age at MIBC diagnosis, sex, histology, lymphovascular invasion, previous non-MIBC, hydronephrosis, and clinical TNM were included in the initial Cox regression model. A risk score was computed based on the final prognostic model and a nomogram was used to estimate BCSS at 2 and 5 years. Results Median age was 66 years; 89% were males; 83% had pure urothelial carcinoma; 16.2% had previous non-MIBC. Clinical stage was T2N0, T3-4aN0, and Tx-4N + in 24%, 57%, and 19% of patients, respectively. Complete pathological response was seen in 29.4% and downstaging to non-MIBC (ypT1, ypTa, ypTis) in 12.5% of patients. Overall 5-year BCSS was 59%. Four prognostic factors were identified: variant histology, previous non-MIBC, female sex and hydronephrosis. By adding the points attributed to each of these factors, we categorized patients in three groups: low-risk (0 points); intermediate-risk (1–9 points); high-risk (≥ 10 points). Five-year BCSS was 72%, 53%, and 15%, respectively ( p  
ISSN:1433-8726
0724-4983
1433-8726
DOI:10.1007/s00345-022-04147-4