To develop and validate a nomogram based on LODDS (Log ODDS of positive lymph-nodes) for prediction of overall survival (OS) in post radical cystectomy (RC) patients of muscle invasive bladder cancer (MIBC).
Materials and Methods
Data was retrospectively collected from 282 cases of MIBC that underwent RC from 2011 to 2017 at our institute. Significant independent predictors were identified using Cox regression model and incorporated into a nomogram to predict 1, 2, and 4-year OS.
Multivariate analysis showed that Neo-Adjuvant Chemo-Therapy (NACT) (P< .001), LODDS (P< .001), T-stage (Pi = .001), CCI (Charlson Comorbidity Index) (P = .034) and grade (P = .003) were independent predictors of OS. The C-index of nomogram (0.740) was higher than that of the American Joint Committee on Cancer (AJCC) staging system (0.614). The bias-corrected calibration plots showed that the predicted risks were in excellent accordance with the actual risks. The results of NRI, IDI, and DCA exhibited superior predictive capability and higher clinical use of the nomogram.
A simple, easy to use nomogram to predict OS in cases of MIBC has been constructed. To best of our knowledge, LODDS has been incorporated for the first time. It has superior predictive ability and higher clinical use than AJCC system. It would help the clinicians for better patient counselling, planning follow-up strategies and designing a clinical trial for newer adjuvant therapy (eg immunotherapy) in post radical cystectomy patients of MIBC.
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- Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA Cancer J Clin. 2021; 71: 209-249
- Risk factors for development of primary bladder squamous cell carcinoma.Ann R Coll Surg Engl. 2017; : 155-160
- Updates in the eighth edition of the Tumor-Node-Metastasis Staging classification for Urologic Cancers.Eur Urol. 2018; 73: 560-569
- Log ODDS (LODDS) of positive lymph nodes as a predictor of overall survival in squamous cell carcinoma of the penis.J Surg Oncol. 2021; 123: 1836-1844
- The tumor-log odds of positive lymph nodes-metastasis staging system, a promising new staging system for gastric cancer after D2 resection in China.PLoS One. 2012; 7: e31736
- Comparison of three lymph node classifications for survival prediction in distant metastatic gastric cancer.Int J Surg. 2016; 35: 165-171
- The prognostic impact of the log odds of positive lymph nodes in colon cancer.Colorectal Disease : official J. Assoc. Coloproctol G. B. Irel. 2014; 16: 0386-0392
- Comparison of nomograms with other methods for predicting outcomes in prostate cancer: a critical analysis of the literature.Clin Cancer Res. 2008; 14: 4400-4407
- Neoadjuvant Cisplatinum Based Combination Chemotherapy in patients with invasive bladder cancer: acombined analysis of two Nordic Studies.European Urology. 2004; 45: 297-303
- Bladder cancer survival nomogram: Development and validation of a prediction tool, using the SEER and TCGA databases.Medicine. 2019; 98: 44
- Nomograms in oncology: more than meets the eye.Lancet Oncol. 2015; 16: e173-e180
- Log odds could better predict survival in muscle-invasive bladder Cancer patients compared with pN and Lymph Node Ratio.J Cancer. 2019; 10: 249-256
- Validation of a combined comorbidity index.J Clin Epidemiol. 1994; 47: 1245-1251
- Partial residuals for The proportional hazards regression model.Biometrika. 1982; 69: 239-241
- How to build and interpret a nomogram for cancer prognosis.J Clin Oncol. 2008; 26: 1364-1370
- Discrimination and calibration of clinical prediction models: users' guides to the medical literature.JAMA. 2017; 318: 1377-1384
- Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond.Stat Med. 2008; 27: 157-172
- Net benefit approaches to the evaluation of prediction models, molecular markers, and diagnostic tests.BMJ. 2016; 352: i6
- Cancer and all-cause Mortality in Bladder Cancer patients undergoing radical Cystectomy: development and validation of a Nomogram for treatment decision-making.Urology. 2017; 110: 76-83
- Nomogram for predicting overall survival of patients with bladder cancer: A population-based study.Intl J Bioll Markers. 2020; 35: 29-39
- Smoking and bladder cancer: asystematic review of risk and outcomes.Eur Urol Focus. 2015; 1: 17-27
- Smoking status is a risk factor for recurrence after transurethral resection of non-muscle-invasive bladder cancer.Eur Urol. 2011; 60: 713-720
- Impact of smoking and smoking cessation on outcomes in bladder cancer patients treated with radical cystectomy.Eur Urol. 2013; 64: 456-464
- Factors affecting recurrence rates in superficial bladder cancer.J Natl Cancer Inst. 1986; 76: 1025-1029
- Smoking behavior and survival outcomes in bladder cancer patients.Urol Sci. 2020; 31: 123-130
- Bladder cancer demographics and outcome data from 2013 at a tertiary cancer hospital in India.Indian J Cancer. 2019; 56: 54-58
- Impact of age and gender on the clinicopathological characteristics of bladder cancer.Indian J Urol. 2009; 25: 207-210
Published online: November 24, 2022
Accepted: November 22, 2022
Received in revised form: November 20, 2022
Received: September 25, 2022
Publication stageIn Press Journal Pre-Proof
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