NOC-UTUC Nomogram: prediction of high-risk nonorgan-confined upper-tract urothelial carcinoma
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
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★★★
Model author
Model ID
1704
Version
1.9
Revision date
2019-01-28
Specialty
MeSH terms
  • Bladder Cancer
  • Model type
    Logistic regression (Calculation)
    Status
    public
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    Formula
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    Condition Formula

    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

    Total population size: 566
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    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

    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

    Result interval {{ additionalResult.min }} to {{ additionalResult.max }}

    Conditional information

    Result interpretation

    This preoperative nomogram can be used to more optimally select patients for preoperative systemic chemotherapy, and facilitate clinical trial enrollment.

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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