Munich, Germany, 8Department of Urology, Baylor College of Medicine, Houston, TX, USA, 9University of .... at least every 3 to 4 months for the first year,.
2010 THE AUTHORS; BJU INTERNATIONAL Urological Oncology
2010 BJU INTERNATIONAL
RISK STRATIFICATION IN T2N0 BLADDER CANCER SONPAVDE ET AL.
BJUI
Prognostic risk stratification of pathological stage T2N0 bladder cancer after radical cystectomy
BJU INTERNATIONAL
Guru Sonpavde1–3, Myrna M. Khan1,2, Robert S. Svatek4, Richard Lee5, Giacomo Novara6, Derya Tilki7, Seth P. Lerner8, Gilad E. Amiel1,8, Eila Skinner9, Pierre I. Karakiewicz10, Patrick J. Bastian7, Wassim Kassouf11, Hans-Martin Fritsche12, Jonathan I. Izawa13, Vincenzo Ficarra6, Colin P. Dinney4, Yair Lotan14, Yves Fradet15 and Shahrokh F. Shariat5 1
Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA, 2Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA, 3Texas Oncology, Houston, TX, USA, 4University of Texas MD Anderson Cancer Center, Houston, TX, USA, 5Department of Urology, Weill Cornell Medical Center, New York, NY, USA, 6University of Padua, Padua, Italy, 7Ludwig-Maximilians-Universität München, Klinikum Grosshadern, Munich, Germany, 8Department of Urology, Baylor College of Medicine, Houston, TX, USA, 9University of Southern California, Los Angeles, CA, USA, 10University of Montréal, Montréal, QC, Canada, 11McGill University Health Centre, Montréal, QC, Canada, 12University of Regensburg, Caritas-St.Josef Medical Center, Regensburg, Germany, 13 University of Western Ontario, London, ON, Canada, 14University of Texas Southwestern Medical Center, Dallas, TX, USA, and 15Laval University, Québec City, QC, Canada Accepted for publication 1 September 2010 Presented in part as a podium presentation at the American Urological Association (AUA) Annual Conference May 2010, San Francisco, CA, USA.
Study Type – Therapy (individual cohort) Level of Evidence 2b OBJECTIVE • To stratify risk of pathological (p) T2N0 urothelial carcinoma of the bladder after radical cystectomy (RC) based on pathological factors to facilitate the development of adjuvant therapy trials for high-risk patients. PATIENTS AND METHODS • The study comprised 707 patients from a database of patients with pT2N0 urothelial carcinoma of the bladder who had undergone RC and not received perioperative chemotherapy. • The effect of residual pT-stage at RC, age, grade, lymphovascular invasion and number of lymph nodes removed on recurrence-free survival was evaluated using Cox regression analyses. A weighted prognostic model was devised with significant variables. RESULTS • The median follow up was 60.9 months. In multivariable analyses, residual disease at RC
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What’s known on the subject? and What does the study add? Patients with urothelial carcinoma of the bladder (UCB) and pathological (p) stage T2N0 disease exhibit a range of clinical outcomes with an overall estimated 10–25% experiencing recurrence and death after radical cystectomy (RC). Nomograms to prognosticate UCB post-RC have been developed in heterogeneous datasets of patients across different stages and do not address factors unique to pT2N0 disease. A user-friendly prognostic risk model was devised for patients with pT2N0 UCB undergoing RC based on residual pathological stage at RC (pT2a, pT2b,
