Prognostic Model for Predicting Survival in Patients with Disease Recurrence Following Radical Cystectomy

Luis A. Kluth, Evanguelos Xylinas, Malte Rieken, Matthew Kent, Masaomi Ikeda, Kazumasa Matsumoto, Masayuki Hagiwara, Eiji Kikuchi, Megan T. Bing, Amit Gupta, Joseph M. Sewell, Badrinath R. Konety, Tilman Todenhöfer, Christian Schwentner, Alexandra Masson-Lecomte, Dimitri Vordos, Florian Roghmann, Joachim Noldus, Aria A. Razmaria, Norm D. SmithEvi Comploj, Armin Pycha, Michael Rink, Jack Baniel, Roy Mano, Giacomo Novara, Atiqullah Aziz, Hans Martin Fritsche, Antonin Brisuda, Trinity Bivalacqua, Paolo Gontero, Stephen A. Boorjian, Andrew J. Vickers, Shahrokh F. Shariat

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Although the natural history of urothelial carcinoma of the bladder (UCB) from radical cystectomy (RC) to disease recurrence (DR) has been investigated intensively, the course of patients who have experienced DR after RC for UCB remains poorly understood. Objective: To evaluate the prognostic value of the Bajorin criteria that consists of two risk factors: Karnofsky performance status (KPS) and the presence of visceral metastases (VMs) in patients with DR after RC for UCB. Furthermore, to identify additional factors associated with cancer-specific mortality (CSM) and thus build a multivariable model to predict survival after DR. Design, setting, and participants: We identified 967 patients with UCB who underwent RC at 17 centers between 1979 and 2012 and experienced DR. Of these, 372 patients had complete data we used for analysis. Outcomes measurements and statistical analysis: Univariable Cox regressions analysis was performed. We used a forward stepwise selection process for our final multivariable model. Results and limitations: Within a median follow-up of 18 mo, 266 patients died of disease. Cancer-specific survival at 1 yr was 79%, 76%, and 47% for patients with no (n= 105), one (n= 180), and two (n= 87) risk factors (p<0.001; c-index: 0.604). On multivariable analyses, we found that KPS

Original languageEnglish (US)
Pages (from-to)75-81
Number of pages7
JournalEuropean Urology Focus
Volume1
Issue number1
DOIs
StatePublished - Aug 1 2015

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Cystectomy
Recurrence
Survival
Urinary Bladder
Carcinoma
Karnofsky Performance Status
Regression Analysis
Neoplasm Metastasis
Mortality
Neoplasms

Keywords

  • Bladder cancer
  • Disease recurrence
  • Metastasis
  • Model
  • Prognosis
  • Survival
  • Transitional cell carcinoma
  • Urothelial carcinoma of the bladder

ASJC Scopus subject areas

  • Urology

Cite this

Kluth, L. A., Xylinas, E., Rieken, M., Kent, M., Ikeda, M., Matsumoto, K., ... Shariat, S. F. (2015). Prognostic Model for Predicting Survival in Patients with Disease Recurrence Following Radical Cystectomy. European Urology Focus, 1(1), 75-81. https://doi.org/10.1016/j.euf.2014.10.003

Prognostic Model for Predicting Survival in Patients with Disease Recurrence Following Radical Cystectomy. / Kluth, Luis A.; Xylinas, Evanguelos; Rieken, Malte; Kent, Matthew; Ikeda, Masaomi; Matsumoto, Kazumasa; Hagiwara, Masayuki; Kikuchi, Eiji; Bing, Megan T.; Gupta, Amit; Sewell, Joseph M.; Konety, Badrinath R.; Todenhöfer, Tilman; Schwentner, Christian; Masson-Lecomte, Alexandra; Vordos, Dimitri; Roghmann, Florian; Noldus, Joachim; Razmaria, Aria A.; Smith, Norm D.; Comploj, Evi; Pycha, Armin; Rink, Michael; Baniel, Jack; Mano, Roy; Novara, Giacomo; Aziz, Atiqullah; Fritsche, Hans Martin; Brisuda, Antonin; Bivalacqua, Trinity; Gontero, Paolo; Boorjian, Stephen A.; Vickers, Andrew J.; Shariat, Shahrokh F.

In: European Urology Focus, Vol. 1, No. 1, 01.08.2015, p. 75-81.

Research output: Contribution to journalArticle

Kluth, LA, Xylinas, E, Rieken, M, Kent, M, Ikeda, M, Matsumoto, K, Hagiwara, M, Kikuchi, E, Bing, MT, Gupta, A, Sewell, JM, Konety, BR, Todenhöfer, T, Schwentner, C, Masson-Lecomte, A, Vordos, D, Roghmann, F, Noldus, J, Razmaria, AA, Smith, ND, Comploj, E, Pycha, A, Rink, M, Baniel, J, Mano, R, Novara, G, Aziz, A, Fritsche, HM, Brisuda, A, Bivalacqua, T, Gontero, P, Boorjian, SA, Vickers, AJ & Shariat, SF 2015, 'Prognostic Model for Predicting Survival in Patients with Disease Recurrence Following Radical Cystectomy', European Urology Focus, vol. 1, no. 1, pp. 75-81. https://doi.org/10.1016/j.euf.2014.10.003
Kluth, Luis A. ; Xylinas, Evanguelos ; Rieken, Malte ; Kent, Matthew ; Ikeda, Masaomi ; Matsumoto, Kazumasa ; Hagiwara, Masayuki ; Kikuchi, Eiji ; Bing, Megan T. ; Gupta, Amit ; Sewell, Joseph M. ; Konety, Badrinath R. ; Todenhöfer, Tilman ; Schwentner, Christian ; Masson-Lecomte, Alexandra ; Vordos, Dimitri ; Roghmann, Florian ; Noldus, Joachim ; Razmaria, Aria A. ; Smith, Norm D. ; Comploj, Evi ; Pycha, Armin ; Rink, Michael ; Baniel, Jack ; Mano, Roy ; Novara, Giacomo ; Aziz, Atiqullah ; Fritsche, Hans Martin ; Brisuda, Antonin ; Bivalacqua, Trinity ; Gontero, Paolo ; Boorjian, Stephen A. ; Vickers, Andrew J. ; Shariat, Shahrokh F. / Prognostic Model for Predicting Survival in Patients with Disease Recurrence Following Radical Cystectomy. In: European Urology Focus. 2015 ; Vol. 1, No. 1. pp. 75-81.
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T1 - Prognostic Model for Predicting Survival in Patients with Disease Recurrence Following Radical Cystectomy

AU - Kluth, Luis A.

AU - Xylinas, Evanguelos

AU - Rieken, Malte

AU - Kent, Matthew

AU - Ikeda, Masaomi

AU - Matsumoto, Kazumasa

AU - Hagiwara, Masayuki

AU - Kikuchi, Eiji

AU - Bing, Megan T.

AU - Gupta, Amit

AU - Sewell, Joseph M.

AU - Konety, Badrinath R.

AU - Todenhöfer, Tilman

AU - Schwentner, Christian

AU - Masson-Lecomte, Alexandra

AU - Vordos, Dimitri

AU - Roghmann, Florian

AU - Noldus, Joachim

AU - Razmaria, Aria A.

AU - Smith, Norm D.

AU - Comploj, Evi

AU - Pycha, Armin

AU - Rink, Michael

AU - Baniel, Jack

AU - Mano, Roy

AU - Novara, Giacomo

AU - Aziz, Atiqullah

AU - Fritsche, Hans Martin

AU - Brisuda, Antonin

AU - Bivalacqua, Trinity

AU - Gontero, Paolo

AU - Boorjian, Stephen A.

AU - Vickers, Andrew J.

AU - Shariat, Shahrokh F.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background: Although the natural history of urothelial carcinoma of the bladder (UCB) from radical cystectomy (RC) to disease recurrence (DR) has been investigated intensively, the course of patients who have experienced DR after RC for UCB remains poorly understood. Objective: To evaluate the prognostic value of the Bajorin criteria that consists of two risk factors: Karnofsky performance status (KPS) and the presence of visceral metastases (VMs) in patients with DR after RC for UCB. Furthermore, to identify additional factors associated with cancer-specific mortality (CSM) and thus build a multivariable model to predict survival after DR. Design, setting, and participants: We identified 967 patients with UCB who underwent RC at 17 centers between 1979 and 2012 and experienced DR. Of these, 372 patients had complete data we used for analysis. Outcomes measurements and statistical analysis: Univariable Cox regressions analysis was performed. We used a forward stepwise selection process for our final multivariable model. Results and limitations: Within a median follow-up of 18 mo, 266 patients died of disease. Cancer-specific survival at 1 yr was 79%, 76%, and 47% for patients with no (n= 105), one (n= 180), and two (n= 87) risk factors (p<0.001; c-index: 0.604). On multivariable analyses, we found that KPS

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KW - Transitional cell carcinoma

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