scholarly journals External validation of radical cystectomy pentafecta, achievement assessment and its association with surgical experience

2021 ◽  
Vol 33 ◽  
pp. S69-S70
Author(s):  
P. Piazza ◽  
C.A. Bravi ◽  
S. Puliatti ◽  
G.E. Cacciamani ◽  
S. Knipper ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
External Validation ◽  
Surgical Experience ◽  
Achievement Assessment

scholarly journals Multicenter external validation of the radical cystectomy pentafecta in a European cohort of patients undergoing robot-assisted radical cystectomy with intracorporeal urinary diversion for bladder cancer

2021 ◽  
Author(s):  
P. Baron ◽  
Z. Khene ◽  
F. Lannes ◽  
G. Pignot ◽  
A. S. Bajeot ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Independent Predictor ◽  
External Validation ◽  
Surgical Experience ◽  
Multivariable Logistic Regression Model ◽  
Clinical Recurrence ◽  
Surgeon Experience ◽  
The Impact

Abstract Objective To perform an external validation of this RC-pentafecta. Method Between January 2014 and December 2019, 104 consecutive patients who underwent RARC with ICUD within 6 urological centers were analyzed retrospectively. Patients who simultaneously demonstrated negative soft tissue surgical margins (STSMs), a lymph node (LN) yield ≥ 16, absence of major (Clavien–Dindo grade III–V) 90-day postoperative complications, absence of UD-related long-term sequelae, and absence of 12-month clinical recurrence were considered to have achieved RC-pentafecta. A multivariable logistic regression model was used to measure predictors for achieving RC-pentafecta. We analyzed the influence of this RC-pentafecta on survival, and the impact ofthe surgical experience. Results Since 2014, 104 patients who had completed at least 12 months of follow-up were included. Over a mean follow-up of 18 months, a LN yield ≥ 16, negative STSMs, absence of major complications at 90 days, and absence of UD-related surgical sequelae and clinical recurrence at ≤ 12 months were observed in 56%, 96%, 85%, 81%, and 91% of patients, respectively, resulting in a RC-pentafecta rate of 39.4%. Multivariate analysis showed that age was an independent predictor of pentafecta achievement (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.90. 0.99; p = 0.04). The surgeon experience had an impact on the validation of the criteria. Conclusion This study confirmed that the RC-pentafecta is reproducible and could be externally used for the outcome assessment after RARC with ICUD. Therefore, the RC-pentafecta could be a useful tool to assess surgical success and its impact on different outcomes.

scholarly journals Multifactorial, Site-Specific Recurrence Models after Radical Cystectomy for Urothelial Carcinoma: External Validation in a Cohort of Korean Patients

PLoS ONE ◽  
2014 ◽  
Vol 9 (6) ◽  
pp. e100491 ◽  
Author(s):  
Hyung Suk Kim ◽  
Myong Kim ◽  
Chang Wook Jeong ◽  
Cheol Kwak ◽  
Hyeon Hoe Kim ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
External Validation ◽  
Site Specific ◽  
Korean Patients

PD18-10 THE TNR-C SCORE QUALIFIES AS A PROGNOSTIC TOOL FOR PATIENTS UNDERGOING RADICAL CYSTECTOMY: RESULTS OF AN EXTERNAL VALIDATION

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Mario Kramer ◽  
Annika Heinisch ◽  
Mahmoud Abbas ◽  
Gerd Wegener ◽  
Inga Peters ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
External Validation ◽  
Prognostic Tool

Development of a genomic-clinical classifier for predicting progression after radical cystectomy in patients with muscle invasive bladder cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4542-4542
Author(s):  
Anirban Pradip Mitra ◽  
Nicholas Erho ◽  
Lucia L.C. Lam ◽  
Ismael A. Vergara ◽  
Thomas Sierocinski ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Cancer Progression ◽  
External Validation ◽  
Multivariable Analysis ◽  
Invasive Bladder Cancer ◽  
K Nearest Neighbor ◽  
Muscle Invasive Bladder Cancer ◽  
Validation Set ◽  
Muscle Invasive

4542 Background: The mainstay of muscle-invasive bladder cancer treatment is surgical resection with/without multi-agent chemotherapy. Management decisions are based on a small number of clinical and pathologic parameters with poor prognostic and predictive power. There is an urgent need for enhanced biomarkers to guide therapy of this lethal disease. Here we have developed a genomic signature of bladder cancer progression using whole transcriptome profiling technology. Methods: 251 FFPE bladder cancer specimens were obtained from patients undergoing radical cystectomy at the University of Southern California (1998-2004). All patients had pT2-T4a,N0 urothelial carcinoma in the absence of pre-operative chemotherapy. Median follow-up was 5 years. RNA expression levels were measured with 1.4 million feature oligonucleotide microarrays. Patients were divided into a training set (2/3 of cohort) to develop a genomic classifier for risk of progression (defined as any type of bladder cancer recurrence), and a validation set (1/3 of cohort). In parallel, multivariable analysis was used to develop a clinical classifier using typical clinical and pathologic variables. Finally, a genomic-clinical classifier was built combining the genomic classifier with clinical variables using logistic regression. The receiver-operator characteristic (ROC) area under the curve (AUC) metric was used to evaluate each classifier in the validation set. Results: The genomic classifier consisted of 89 features corresponding to 80 genes that were combined in a k-nearest neighbor model (KNN89). KNN89 showed an AUC of 0.77 in ROC analysis on the validation set. The best clinical classifier showed an AUC of 0.72. The genomic-clinical classifier demonstrated an AUC of 0.81. Multivariable analysis incorporating all clinical parameters and KNN89 further revealed that KNN89 was the only significant predictor of bladder cancer progression (p=0.0077). Conclusions: We have developed a combined genomic-clinical classifier that shows improved performance over clinical models alone for prediction of progression after radical cystectomy. External validation of this classifier is ongoing.

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