This study aims to develop a prognostic model that estimates the post-operative risk of cancer-specific mortality in patients with bladder cancer who underwent radical cystectomy (RC).

Methods

We analyzed the data from patients with bladder cancer who had undergone radical cystectomy without receiving adjuvant chemotherapy across 36 institutions in the Japan Urological Oncology Group. The data were randomly split into training (N = 1348) and validation sets (N = 674) in a 2:1 ratio. Twenty-five variables were analyzed, and a multivariable Cox regression model predicting cancer-specific mortality was developed and validated. Prognostic scores were categorized into good and poor prognostic groups based on the upper tertile. The performance of the model was compared against the CheckMate 274 risk classification as a reference, which is used for determining the indication of adjuvant nivolumab therapy.

Results

The final model incorporated eight variables. In the validation set, it outperformed the CheckMate 274 risk classification with superior time-dependent area under the curves (5-year: 0.81 vs. 0.67) and was well-calibrated. Furthermore, our model reclassified 27.8% of patients categorized as high-risk by the CheckMate 274 risk classification into the good prognosis group.

Conclusions

We developed and validated a prognostic model for patients with bladder cancer who underwent RC. This model will be beneficial in identifying patients with poor prognosis and those who are potential candidates for clinical trials of adjuvant therapy.

CONFLICT OF INTEREST STATEMENT

Wataru Fukuokaya certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (e.g., employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents led, received, or pending), are the following: All authors declare no conflicts of interest associated with this manuscript. Hiroyuki Nishiyama, Takahiro Kimura, and Shingo Hatakeyama are the Editorial Board members of International Journal of Urology and co-authors of this article. To minimize bias, they were excluded from all editorial decision-making related to the acceptance of this article for publication.

Supporting Information

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Volume31, Issue12

December 2024

Pages 1414-1422

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iju15585-sup-0007-TableS1.xlsxExcel 2007 spreadsheet , 10.4 KB	Table S1.
iju15585-sup-0008-TableS2.xlsxExcel 2007 spreadsheet , 12.7 KB	Table S2.

Development and validation of a model to predict the outcomes of radical cystectomy in patients with bladder cancer

Abstract

Objectives

Methods

Results

Conclusions

CONFLICT OF INTEREST STATEMENT

Supporting Information

REFERENCES

References

Information

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Development and validation of a model to predict the outcomes of radical cystectomy in patients with bladder cancer

Abstract

Objectives

Methods

Results

Conclusions

CONFLICT OF INTEREST STATEMENT

Supporting Information

REFERENCES

References

Related

Information