scholarly journals Development and Validation of a Prognostic Nomogram in Patients with Bladder Cancer after Radical Cystectomy: A Study Based on the Chinese Population

2021 ◽  
Author(s):  
Xun Lu ◽  
Yiduo Wang ◽  
Qi Chen ◽  
Di Xia ◽  
Hanyu Zhang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Validation Cohort ◽  
Disease Free Survival ◽  
Calibration Plot ◽  
Concordance Index ◽  
Free Survival ◽  
Training Cohort ◽  
Disease Free

Abstract PurposeTo develop and validate a prognostic nomogram in patients with bladder cancer who underwent radical cystectomy based on the Chinese population.MethodsThe nomogram was built on a retrospective study included 191 patients with bladder cancer who underwent radical cystectomy between January 2010 to December 2019 at the authors’ hospital. The primary cohort was divided into the training cohort and the validation cohort randomly. The endpoints in the study were disease-free survival and overall survival. The ability of distinguishing and predicting of the prognostic nomogram were determined by calibration plot and concordance index in the training cohort. Moreover, the results were also verified in the validation cohort internally.ResultsMultivariate analysis of the training cohort showed that hydronephrosis, Stage_T, Stage_N, PNI and EGFR were significantly associated with overall survival. Meanwhile, Stage_T, Stage_N, PNI and EGFR were independent risk factors for disease-free survival. The calibration plot agreed well between prediction and actual observation in survival possibility. The concordance index of the nomogram in the training cohort of overall survival and disease-free survival were 0.834 (95%CI: 0.785-0.833) and 0.823 (95%CI: 0.772-0.873), respectively. In the validation cohort, the nomogram also showed high predictive accuracy.ConclusionThe proposed nomogram showed high accuracy in predicting survival for bladder cancer patients after radical cystectomy.

Feasibility and efficacy of gemcitabine and carboplatin neoadjuvant chemotherapy in muscle-invasive bladder cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16100-e16100
Author(s):  
T. Koie ◽  
H. Yamamoto ◽  
A. Okamoto ◽  
S. Hatakeyama ◽  
A. Momose ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Objective Response ◽  
Disease Free Survival ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Free Survival ◽  
Muscle Invasive ◽  
Disease Free

e16100 Background: The neoadjuvant M-VAC followed by radical cystectomy for muscle-invasive bladder cancer has improved survival compared to radical cystectomy alone. Nevertheless, M-VAC has been associated with severe toxicity. The objective of this retrospective study was to evaluate the objective response rate, the impact on overall survival, disease-free survival, disease-free survival and toxicity adverse events of gemcitabine and carboplatin (GC) neoadjuvant chemotherapy in patients with locally advanced bladder cancer. Methods: We reviewed the clinical and pathological data of 140 patients who underwent radical cystectomy and bilateral pelvic lymphadenectomy for T2N0M0 to T4aN0M0 bladder cancer at our institution between January 2001 and August 2008. Seventy patients were treated with neoadjuvant GC followed by cystectomy between March 2005 and August 2008 (GC group), and 70 patients were treated with cystectomy alone between January 2001 and May 2007 (cystectomy alone group). In the GC group, the patients received 2 courses of GC therapy consisted of 800mg/m2 gemcitabine on days 1, 8, and 15 and carboplatin (AUC 4) on day 2. The primary endpoint was the objective response rate, and the secondary endpoints were overall survival, cancer-specific survival, disease free survival, and toxicity. Results: Fifteen patients (23.8%) had a complete response and 26 patients (41.3%) had a partial response in the GC group. At a mean follow-up period of 26.7 months, the overall survival was 85.0% in the GC group and 47.8% in the cystectomy alone group (p = 0.003). The cancer-specific survival was 78.4% in the GC group and 44.6% in the cystectomy alone group (p = 0.0018). The disease-free survival was 82.9% in the GC group and 35.7% in the cystectomy alone group (p = 0.0001). Hematologic toxicities were the main adverse events. Grade 3/4 neutropenia occurred in 26 patients (37.1%) and thrombocytopenia in 15 (21.4%). There was no grade 3/4 gastrointestinal toxicity and no renal function abnormalities. Conclusions: Although this is not a randomized study, the GC neoadjuvant therapy followed by radical cystectomy is feasible and may be associated with improved survival among patients with muscle-invasive bladder cancer. A randomized trial is warranted. No significant financial relationships to disclose.

602 The extent of lymphadenectomy in radical cystectomy for bladder cancer influences disease-free survival

2012 ◽  
Vol 11 (1) ◽  
pp. e602
Author(s):  
D. Tilki ◽  
H. Abol-Enein ◽  
A. Mosbah ◽  
M. El-Baz ◽  
A. Shokeir ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

Gene Expression Profiling Reveals a New Classification of Adrenocortical Tumors and Identifies Molecular Predictors of Malignancy and Survival

2009 ◽  
Vol 27 (7) ◽  
pp. 1108-1115 ◽  
Author(s):  
Aurélien de Reyniès ◽  
Guillaume Assié ◽  
David S. Rickman ◽  
Frédérique Tissier ◽  
Lionel Groussin ◽  
...  
Keyword(s):  
Gene Expression ◽  
Validation Cohort ◽  
Malignant Tumors ◽  
Disease Free Survival ◽  
Free Survival ◽  
Training Cohort ◽  
Adrenocortical Tumors ◽  
Independent Validation ◽  
Gene Predictor ◽  
Disease Free

Purpose Adrenocortical tumors, especially cancers, remain challenging both for their diagnosis and prognosis assessment. The aim of this article is to identify molecular predictors of malignancy and of survival. Patients and Methods One hundred fifty-three unilateral adrenocortical tumors were studied by microarray (n = 92) or reverse transcription quantitative polymerase chain reaction (n = 148). A two-gene predictor of malignancy was built using the disease-free survival as the end point in a training cohort (n = 47), then validated in an independent validation cohort (n = 104). The best candidate genes were selected using Cox models, and the best gene combination was validated using the log-rank test. Similarly, for malignant tumors, a two-gene predictor of survival was built using the overall survival as the end point in a training cohort (n = 23), then tested in an independent validation cohort (n = 35). Results Unsupervised clustering analysis discriminated robustly the malignant and benign tumors, and identified two groups of malignant tumors with very different outcome. The combined expression of DLG7 and PINK1 was the best predictor of disease-free survival (log-rank P ≈ 10−12), could overcome the uncertainties of intermediate pathological Weiss scores, and remained significant after adjustment to the Weiss score (P < 1.3 × 10−2). Among the malignant tumors, the combined expression of BUB1B and PINK1 was the best predictor of overall survival (P < 2 × 10−6), and remained significant after adjusting for MacFarlane staging (P < .005). Conclusion Gene expression analysis unravels two distinct groups of adrenocortical carcinomas. The molecular predictors of malignancy and of survival are reliable and provide valuable independent information in addition to pathology and tumor staging. These original tools should provide important improvements for adrenal tumors management.

scholarly journals Complete TURBT Before Radical Cystectomy Did Not Improve Oncological Outcome for Organ-Confined Bladder Cancer

2020 ◽  
Author(s):  
Hai-tao Liang ◽  
Zhan-ping Xu ◽  
Zhi-jun Lin ◽  
Zi-ke Qin ◽  
Yun-lin Ye
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Tumor Size ◽  
Surgical Margin ◽  
Disease Free Survival ◽  
Positive Surgical Margin ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Histological Variants ◽  
Disease Free

Abstract Background To investigate the role of complete transurethral resection of bladder tumor (TURBT) before radical cystectomy for organ-confined bladder cancer.Patients and Methods Patients who underwent radical cystectomy (RC) in our center from January 2008 to December 2018 were retrospectively reviewed. Those with disease >T2N0M0 or positive surgical margin and those who were administrated neoadjuvant/adjuvant chemotherapy or radiotherapy were excluded. Complete TURBT was defined as no visible lesion under endoscopic examination after TURBT or specimen of RC. Kaplan–Meier and log-rank tests assessed disease-free survival. Logistic and Cox regression analysis were performed to identify potential predictors.Results In total, 236 patients were included, and 207 patients were male. The median age was 61 years old. The median number and size were 1 and 3cm respectively, and maximal pathological T stage was T2 in 94 patients. Complete TURBT was related to tumor size (p=0.041), histological variants (p=0.026) and downstaging (p<0.001). Tumor size, grade and histological variants were independent predictors of complete TURBT. With a median follow-up of 42.7 months, 30 patients experienced recurrence. Age and histological variantswere independent predictors of disease-free survival (p=0.022 and 0.032, respectively), and complete TURBT was not an independent predictor of disease-free survival (p=0.156). Downstaging was not associated with survival outcome.Conclusions Complete TURBT is related to an increased rate of downstaging before radical cystectomy, and it was not associated with better oncological outcomes for patients with organ-confined bladder cancer.

Does the Extent of Lymphadenectomy in Radical Cystectomy for Bladder Cancer Influence Disease-Free Survival? A Prospective Single-Center Study

2011 ◽  
Vol 60 (3) ◽  
pp. 572-577 ◽  
Author(s):  
Hassan Abol-Enein ◽  
Derya Tilki ◽  
Ahmed Mosbah ◽  
Mahmoud El-Baz ◽  
Ahmed Shokeir ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Disease Free Survival ◽  
Single Center ◽  
Free Survival ◽  
Single Center Study ◽  
Disease Free ◽  
Center Study

scholarly journals Complete TURBT before Radical Cystectomy is not a Risk Factor for Organ-Confined Bladder Cancer: A Case Control Study

2021 ◽  
Author(s):  
Mingrui Luo ◽  
Zhan-ping Xu ◽  
Zhi-jun Lin ◽  
Zi-ke Qin ◽  
Yun-lin Ye
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Tumor Size ◽  
Surgical Margin ◽  
Disease Free Survival ◽  
Positive Surgical Margin ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Histological Variants ◽  
Disease Free

Abstract Background To investigate the role of complete transurethral resection of bladder tumor (TURBT) before radical cystectomy for organ-confined bladder cancer.Patients and MethodsPatients who underwent radical cystectomy (RC) in our center from January 2008 to December 2018 were retrospectively reviewed. Those with disease >T2N0M0 or positive surgical margin and those who were administrated neoadjuvant/adjuvant chemotherapy or radiotherapy were excluded. Complete TURBT was defined as no visible lesion under endoscopic examination after TURBT or specimen of RC. Kaplan–Meier and log-rank tests assessed disease-free survival. Logistic and Cox regression analysis were performed to identify potential predictors.ResultsIn total, 236 patients were included, and 207 patients were male. The median age was 61 years old. The median number and size were 1 and 3cm respectively, and maximal pathological T stage was T2 in 94 patients. Complete TURBT was related to tumor size (p=0.041), histological variants (p=0.026) and downstaging (p<0.001). Tumor size, grade and histological variants were independent predictors of complete TURBT. With a median follow-up of 42.7 months, 30 patients experienced recurrence. Age and histological variantswere independent predictors of disease-free survival (p=0.022 and 0.032, respectively), and complete TURBT was not an independent predictor of disease-free survival (p=0.156). Downstaging was not associated with survival outcome.Conclusions Complete TURBT is related to an increased rate of downstaging before radical cystectomy, and it was not associated with better oncological outcomes for patients with organ-confined bladder cancer.

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