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Risk stratification for locoregional recurrence after radical cystectomy for urothelial carcinoma of the bladder

Standard

Risk stratification for locoregional recurrence after radical cystectomy for urothelial carcinoma of the bladder. / Novotny, Vladimir; Froehner, Michael; May, Matthias; Protzel, Chris; Hergenröther, Katrin; Rink, Michael; Chun, Felix K; Fisch, Margit; Roghmann, Florian; Palisaar, Rein-Jüri; Noldus, Joachim; Gierth, Michael; Fritsche, Hans-Martin; Burger, Maximilian; Sikic, Danijel; Keck, Bastian; Wullich, Bernd; Nuhn, Philipp; Buchner, Alexander; Stief, Christian G; Vallo, Stefan; Bartsch, Georg; Haferkamp, Axel; Bastian, Patrick J; Hakenberg, Oliver W; Propping, Stefan; Aziz, Atiqullah.

in: WORLD J UROL, Jahrgang 33, Nr. 11, 08.02.2015, S. 1753-1761.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Novotny, V, Froehner, M, May, M, Protzel, C, Hergenröther, K, Rink, M, Chun, FK, Fisch, M, Roghmann, F, Palisaar, R-J, Noldus, J, Gierth, M, Fritsche, H-M, Burger, M, Sikic, D, Keck, B, Wullich, B, Nuhn, P, Buchner, A, Stief, CG, Vallo, S, Bartsch, G, Haferkamp, A, Bastian, PJ, Hakenberg, OW, Propping, S & Aziz, A 2015, 'Risk stratification for locoregional recurrence after radical cystectomy for urothelial carcinoma of the bladder', WORLD J UROL, Jg. 33, Nr. 11, S. 1753-1761. https://doi.org/10.1007/s00345-015-1502-y

APA

Novotny, V., Froehner, M., May, M., Protzel, C., Hergenröther, K., Rink, M., Chun, F. K., Fisch, M., Roghmann, F., Palisaar, R-J., Noldus, J., Gierth, M., Fritsche, H-M., Burger, M., Sikic, D., Keck, B., Wullich, B., Nuhn, P., Buchner, A., ... Aziz, A. (2015). Risk stratification for locoregional recurrence after radical cystectomy for urothelial carcinoma of the bladder. WORLD J UROL, 33(11), 1753-1761. https://doi.org/10.1007/s00345-015-1502-y

Vancouver

Novotny V, Froehner M, May M, Protzel C, Hergenröther K, Rink M et al. Risk stratification for locoregional recurrence after radical cystectomy for urothelial carcinoma of the bladder. WORLD J UROL. 2015 Feb 8;33(11):1753-1761. https://doi.org/10.1007/s00345-015-1502-y

Bibtex

@article{434f155c14e44601ae56488824760dd2,
title = "Risk stratification for locoregional recurrence after radical cystectomy for urothelial carcinoma of the bladder",
abstract = "PURPOSE: To externally validate the Christodouleas risk model incorporating pathological tumor stage, lymph node (LN) count and soft tissue surgical margin (STSM) and stratifying patients who develop locoregional recurrence (LR) after radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). In addition, we aimed to generate a new model including established clinicopathological features that were absent in the Christodouleas risk model.METHODS: Prospectively assessed multicenter data from 565 patients undergoing RC for UCB in 2011 qualified for final analysis. For the purpose of external validation, risk group stratification according to Christodouleas was performed. Competing-risk models were calculated to compare the cumulative incidences of LR after RC.RESULTS: After a median follow-up of 25 months (interquartile range 19-29), the LR-rate was 11.5 %. The Christodouleas model showed a predictive accuracy of 83.2 % in our cohort. In multivariable competing-risk analysis, tumor stage ≥pT3 (HR 4.32, p < 0.001), positive STSM (HR 2.93, p = 0.005), lymphovascular invasion (HR 3.41, p < 0.001), the number of removed LNs <10 (HR 2.62, p < 0.001) and the administration of adjuvant chemotherapy (HR 0.40, p = 0.008) independently predicted the LR-rate. The resulting risk groups revealed significant differences in LR-rates after 24 months with 4.8 % for low-risk patients, 14.7 % for intermediate-risk patients and 38.9 % for high-risk patients (p < 0.001 for all), with a predictive accuracy of 85.6 %, respectively.CONCLUSIONS: The Christodouleas risk model has been successfully externally validated in the present prospective series. However, this analysis finds that overall model performance may be improved by incorporating lymphovascular invasion. After external validation of the newly proposed risk model, it may be used to identify patients who benefit from an adjuvant therapy and suit for inclusion in clinical trials.",
author = "Vladimir Novotny and Michael Froehner and Matthias May and Chris Protzel and Katrin Hergenr{\"o}ther and Michael Rink and Chun, {Felix K} and Margit Fisch and Florian Roghmann and Rein-J{\"u}ri Palisaar and Joachim Noldus and Michael Gierth and Hans-Martin Fritsche and Maximilian Burger and Danijel Sikic and Bastian Keck and Bernd Wullich and Philipp Nuhn and Alexander Buchner and Stief, {Christian G} and Stefan Vallo and Georg Bartsch and Axel Haferkamp and Bastian, {Patrick J} and Hakenberg, {Oliver W} and Stefan Propping and Atiqullah Aziz",
year = "2015",
month = feb,
day = "8",
doi = "10.1007/s00345-015-1502-y",
language = "English",
volume = "33",
pages = "1753--1761",
journal = "WORLD J UROL",
issn = "0724-4983",
publisher = "Springer",
number = "11",

}

RIS

TY - JOUR

T1 - Risk stratification for locoregional recurrence after radical cystectomy for urothelial carcinoma of the bladder

AU - Novotny, Vladimir

AU - Froehner, Michael

AU - May, Matthias

AU - Protzel, Chris

AU - Hergenröther, Katrin

AU - Rink, Michael

AU - Chun, Felix K

AU - Fisch, Margit

AU - Roghmann, Florian

AU - Palisaar, Rein-Jüri

AU - Noldus, Joachim

AU - Gierth, Michael

AU - Fritsche, Hans-Martin

AU - Burger, Maximilian

AU - Sikic, Danijel

AU - Keck, Bastian

AU - Wullich, Bernd

AU - Nuhn, Philipp

AU - Buchner, Alexander

AU - Stief, Christian G

AU - Vallo, Stefan

AU - Bartsch, Georg

AU - Haferkamp, Axel

AU - Bastian, Patrick J

AU - Hakenberg, Oliver W

AU - Propping, Stefan

AU - Aziz, Atiqullah

PY - 2015/2/8

Y1 - 2015/2/8

N2 - PURPOSE: To externally validate the Christodouleas risk model incorporating pathological tumor stage, lymph node (LN) count and soft tissue surgical margin (STSM) and stratifying patients who develop locoregional recurrence (LR) after radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). In addition, we aimed to generate a new model including established clinicopathological features that were absent in the Christodouleas risk model.METHODS: Prospectively assessed multicenter data from 565 patients undergoing RC for UCB in 2011 qualified for final analysis. For the purpose of external validation, risk group stratification according to Christodouleas was performed. Competing-risk models were calculated to compare the cumulative incidences of LR after RC.RESULTS: After a median follow-up of 25 months (interquartile range 19-29), the LR-rate was 11.5 %. The Christodouleas model showed a predictive accuracy of 83.2 % in our cohort. In multivariable competing-risk analysis, tumor stage ≥pT3 (HR 4.32, p < 0.001), positive STSM (HR 2.93, p = 0.005), lymphovascular invasion (HR 3.41, p < 0.001), the number of removed LNs <10 (HR 2.62, p < 0.001) and the administration of adjuvant chemotherapy (HR 0.40, p = 0.008) independently predicted the LR-rate. The resulting risk groups revealed significant differences in LR-rates after 24 months with 4.8 % for low-risk patients, 14.7 % for intermediate-risk patients and 38.9 % for high-risk patients (p < 0.001 for all), with a predictive accuracy of 85.6 %, respectively.CONCLUSIONS: The Christodouleas risk model has been successfully externally validated in the present prospective series. However, this analysis finds that overall model performance may be improved by incorporating lymphovascular invasion. After external validation of the newly proposed risk model, it may be used to identify patients who benefit from an adjuvant therapy and suit for inclusion in clinical trials.

AB - PURPOSE: To externally validate the Christodouleas risk model incorporating pathological tumor stage, lymph node (LN) count and soft tissue surgical margin (STSM) and stratifying patients who develop locoregional recurrence (LR) after radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). In addition, we aimed to generate a new model including established clinicopathological features that were absent in the Christodouleas risk model.METHODS: Prospectively assessed multicenter data from 565 patients undergoing RC for UCB in 2011 qualified for final analysis. For the purpose of external validation, risk group stratification according to Christodouleas was performed. Competing-risk models were calculated to compare the cumulative incidences of LR after RC.RESULTS: After a median follow-up of 25 months (interquartile range 19-29), the LR-rate was 11.5 %. The Christodouleas model showed a predictive accuracy of 83.2 % in our cohort. In multivariable competing-risk analysis, tumor stage ≥pT3 (HR 4.32, p < 0.001), positive STSM (HR 2.93, p = 0.005), lymphovascular invasion (HR 3.41, p < 0.001), the number of removed LNs <10 (HR 2.62, p < 0.001) and the administration of adjuvant chemotherapy (HR 0.40, p = 0.008) independently predicted the LR-rate. The resulting risk groups revealed significant differences in LR-rates after 24 months with 4.8 % for low-risk patients, 14.7 % for intermediate-risk patients and 38.9 % for high-risk patients (p < 0.001 for all), with a predictive accuracy of 85.6 %, respectively.CONCLUSIONS: The Christodouleas risk model has been successfully externally validated in the present prospective series. However, this analysis finds that overall model performance may be improved by incorporating lymphovascular invasion. After external validation of the newly proposed risk model, it may be used to identify patients who benefit from an adjuvant therapy and suit for inclusion in clinical trials.

U2 - 10.1007/s00345-015-1502-y

DO - 10.1007/s00345-015-1502-y

M3 - SCORING: Journal article

C2 - 25663359

VL - 33

SP - 1753

EP - 1761

JO - WORLD J UROL

JF - WORLD J UROL

SN - 0724-4983

IS - 11

ER -