Abstract
Background
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.
Results
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.
Conclusion
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.
Keywords
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Article info
Publication history
Published online: November 24, 2022
Accepted:
November 22,
2022
Received in revised form:
November 20,
2022
Received:
September 25,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
