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The current multivariable model showed clinical stage, biopsy tumor grade, tumor architecture, and hemoglobin level were independently associated with nonorgan-confined upper-tract urothelial carcinoma NOC-UTUC.
Research authors: Firas G. Petros, Wei Qiao, Nirmish Singla, Timothy N. Clinton, Haley Robyak, Jay D. Raman, Vitaly Margulis, Surena F Matin
Details
Formula
Study characteristics
Files & References
★★★
Model author
Model ID
1704
Version
1.9
Revision date
2019-01-28
MeSH terms
Model type
Logistic regression
(Calculation)
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Additional information
Retrospective evaluation of 699 patients undergoing radical nephroureterectomy at 3 academic centers. Multiplex preoperative patient, imaging, endoscopic, and laboratory values were evaluated. Model derivation and validation were based on a split-sample method. Patients were divided randomly into a development (training) cohort (70% of patients) and validation (test) cohort (30% of patients). Univariate and multivariate logistic regression addressed the prediction of NOC disease (pT3/pT4 and/or pN+) based on training cohort. A backward stepdown selection process achieved the most informative nomogram. The ROC analysis identified a cut-off point predicting high-risk disease. The test cohort served as “external” validation to verify the findings based on the training cohort. Bootstrap resampling was conducted for both internal and “external” validation to evaluate the model fitting.Study Population
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Continuous characteristics
| Name | Mean | SD | Unit |
|---|---|---|---|
| Age | 69.7 | 10.7 | years |
| Tumor size | 3.63 | 2.4 | cm |
| N:L ratio | 3.9 | 3.88 | ratio |
| Serum Na | 139.9 | 3.32 | mEq/L |
| eGFR | 60.6 | 22.4 | ml/min/1.73m2 |
| Hgb | 12.8 | 1.76 | g/dL |
| Albumin | 4.1 | 0.42 | g/dL |
Categorical characteristics
| Name | Subset / Group | Nr. of patients |
|---|---|---|
| Cohort | Development | 396 |
| Validation | 170 | |
| Race | Caucasian | 462 |
| Non-caucasian | 79 | |
| Symptoms | None | 134 |
| Local (gross hematuria/flank pain) | 345 | |
| Systemic | 17 | |
| ECOG performance status | 0-1 | 459 |
| 2-3 | 67 | |
| CCI | 0, 1, 2, 3 | 151 |
| >3 | 295 | |
| Year of surgery | <1999 | 57 |
| 2000-2009 | 245 | |
| ≥2010 | 264 | |
| Hydronephrosis | None/mild | 352 |
| Moderate/severe | 163 | |
| Tumor location | Renal pelvis/calyces | 259 |
| Ureter | 247 | |
| Both | 51 | |
| Focality | Unifocal | 336 |
| Multifocal | 109 | |
| Infiltrative component | Absent | 370 |
| Present | 46 | |
| Clinical stage | cTx, cTa, cTis | 290 |
| cT1-cT2 | 31 | |
| cT3 | 46 | |
| Biopsy tumor grade | Low | 140 |
| High | 224 | |
| Tumor architecture | Papillary | 433 |
| Sessile | 52 |
Related files
| Preview | Name | Tags |
|---|---|---|
|
862.75 kB | Figure (results-page) |
Supporting Publications
| Title or description | Tags |
|---|---|
| Preoperative multiplex nomogram for prediction of high-risk nonorgan-confined upper-tract urothelial carcinoma. | Internal validation Peer review |
Probability of stage pT3/pT4 and pN+ is: ...
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Result
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Probability of stage pT3/pT4 and pN+ is:
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Outcome stratification
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Conditional information
Result interpretation
This preoperative nomogram can be used to more optimally select patients for preoperative systemic chemotherapy, and facilitate clinical trial enrollment.
Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.
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