scholarly journals A Model for the Prediction of Survival in Patients With Upper Tract Urothelial Carcinoma After Surgery

Dose-Response ◽  
2019 ◽  
Vol 17 (4) ◽  
pp. 155932581988287
Author(s):  
Guang-lin Zhang ◽  
Wei Zhou
Keyword(s):  
Urothelial Carcinoma ◽  
Predictive Ability ◽  
Staging System ◽  
Tnm Staging ◽  
Upper Tract Urothelial Carcinoma ◽  
Cancer Specific Survival ◽  
Upper Tract ◽  
Tnm Staging System ◽  
Prediction Of Survival ◽  
Validation Set

Objective: We aimed to formulate and validate prognostic nomograms that can be used to predict the prognosis of patients with upper tract urothelial carcinoma (UTUC). Methods: By consulting the Surveillance, Epidemiology, and End Results (SEER) database, we identified patients who were surgically treated for UTUC between 2004 and 2013. Variables were analyzed in both univariate and multivariate analyses. Nomograms were constructed based on independent prognostic factors. The prognostic nomogram models were established and validated internally and externally to determine their ability to predict the survival of patients with UTUC. Results: A total of 4990 patients were collected and enrolled in our analyses. Of these, 3327 patients were assigned to the training set and 1663 to the validation set. Nomograms were effectively applied to predict the 3- and 5-year survivals of patients with UTUC after surgery. The nomograms exhibited better accuracy for predicting overall survival (OS) and cancer-specific survival (CSS) than the tumor-node-metastasis (TNM) staging system and the SEER stage in both the training and validation sets. Calibration curves indicated that the nomograms exhibited high correlation to actual observed results for both OS and CSS. Conclusions: The nomogram models showed stronger predictive ability than the TNM staging system and the SEER stage. Precise estimates of the prognosis of UTUC might help doctors to make better treatment decisions.

Association of PD-L1 expression with cancer-specific survival in upper tract urothelial carcinoma

2017 ◽  
Vol 16 (3) ◽  
pp. e2016
Author(s):  
B. Zhang ◽  
W. Yu ◽  
X.-R. Feng ◽  
Z. Zhao ◽  
Y. Fan ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Cancer Specific Survival ◽  
Upper Tract

scholarly journals Risk stratification by means of biological age-related factors better predicts cancer-specific survival than chronological age in patients with upper tract urothelial carcinoma: a multi-institutional database study

2018 ◽  
Vol 10 (12) ◽  
pp. 403-410 ◽  
Author(s):  
Teruo Inamoto ◽  
Hideyasu Matsuyama ◽  
Naokazu Ibuki ◽  
Kazumasa Komura ◽  
Kiyohide Fujimoto ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Clinical Response ◽  
Treatment Options ◽  
Upper Tract Urothelial Carcinoma ◽  
Biological Age ◽  
Chronological Age ◽  
Related Factors ◽  
Cancer Specific Survival ◽  
Upper Tract ◽  
Age Related

Background: Chronological age is an important factor in determining the treatment options and clinical response of patients with upper tract urothelial carcinoma (UTUC). Much evidence suggests that chronological age alone is an inadequate indicator to predict the clinical response to radical nephroureterectomy (RNU). Patients and methods: We retrospectively reviewed the data from 1510 patients with UTUC (Ta-4) treated by surgery. White blood cell (WBC) count, neutrophil-to-lymphocyte ratio, hemoglobin (Hb), platelets, albumin, alkaline phosphatase, lactate dehydrogenase, creatinine, and corrected calcium were tested by the Spearman correlation to indicate the direction of association with chronological age, which yielded significant, negative associations of Hb ( p < 0.001) and WBC ( p = 0.010) with chronological age. For scoring, we assigned points for these categories as follows; point ‘0’ for Hb >14 (reference) and 13–13.9 [odds ratio (OR): 1.533], point ‘1’ for 12–12.9 (OR: 2.391), point ‘2’ for 11–11.9 (OR: 3.015), and point ‘3’ for <11 (OR: 3.584). For WBC, point ‘1’ was assigned for >9200 (OR: 2.541) and ‘0’ was assigned for the rest; 9200–8500 (reference), 8499–6000 (OR: 0.873), 5999–4500 (OR: 0.772), 4499–3200 (OR: 0.486), and <3200 (OR: 1.277). Results: The 10-year cancer-specific survival (CSS) in the higher risk group with scores of 4 or higher in patients age <60 years was worse than a score of 0, or 1 in age >80 years [mean estimated survival 69.7 months, confidence interval (CI): 33.3–106 versus 103.5. CI: 91–115.9]. The concordance index between biological age scoring and chronological age was 0.704 for CSS and 0.798 for recurrence-free survival. The limitation of the present study is the retrospective nature of the cohort included. Conclusions: The biological age scoring developed for patients with UTUC undergoing RNU. It was applicable to those with localized disease and performed well in diverse age populations.

scholarly journals Integrated analysis of serum lipid profile for predicting clinical outcomes of patients with malignant biliary tumor

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lejia Sun ◽  
Xin Ji ◽  
Dongyue Wang ◽  
Ai Guan ◽  
Yao Xiao ◽  
...  
Keyword(s):  
Serum Lipids ◽  
Predictive Ability ◽  
Staging System ◽  
Tnm Staging ◽  
Integrated Analysis ◽  
Survival Prediction ◽  
Related Factors ◽  
Tnm System ◽  
Tnm Staging System ◽  
Lipid Parameters

Abstract Background Serum lipids were reported to be the prognostic factors of various cancers, but their prognostic value in malignant biliary tumor (MBT) patients remains unclear. Thus we aim to assess and compare prognosis values of different serum lipids, and construct a novel prognostic nomogram based on serum lipids. Methods Patients with a confirmed diagnosis of MBT at our institute from 2003 to 2017 were retrospectively reviewed. Prognosis-related factors were identified via univariate and multivariate Cox regression analyses. Then the novel prognostic nomogram and a 3-tier staging system were constructed based on these factors and further compared to the TNM staging system. Results A total of 368 patients were included in this study. Seven optimal survival-related factors—TC/HDL >  10.08, apolipoprotein B >  0.9 g/L, lipoprotein> 72 mg/L, lymph node metastasis, radical cure, CA199 > 37 U/mL, and tumor differentiation —were included to construct the prognostic nomogram. The C-indexes in training and validation sets were 0.738 and 0.721, respectively. Besides, ROC curves, calibration plots, and decision curve analysis all suggested favorable discrimination and predictive ability. The nomogram also performed better predictive ability than the TNM system and nomogram without lipid parameters. And the staging system based on nomogram also presented better discriminative ability than TNM system (P < 0.001). Conclusions The promising prognostic nomogram based on lipid parameters provided an intuitive method for performing survival prediction and facilitating individualized treatment and was a great complement to the TNM staging system in predicting overall survival.

REMOVAL OF AT LEAST 8 NODES IMPROVES CANCER-SPECIFIC SURVIVAL IN NON METASTATIC PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA

2009 ◽  
Vol 181 (4S) ◽  
pp. 124-124
Author(s):  
Marco Roscigno ◽  
Shahrokh F. Shariat ◽  
Roberto Bertini ◽  
Pierre I Karakiewicz ◽  
Nazareno Suardi ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Cancer Specific Survival ◽  
Upper Tract

scholarly journals Comparison of the Prognostic Value of Ki-67 and Programmed Cell Death Ligand-1 in Patients with Upper Tract Urothelial Carcinoma

2021 ◽  
Vol 10 (16) ◽  
pp. 3728
Author(s):  
Mu-Yao Tsai ◽  
Ping-Chia Chiang ◽  
Chien-Hsu Chen ◽  
Ming-Tse Sung ◽  
Shun-Chen Huang ◽  
...  
Keyword(s):  
Cell Death ◽  
Programmed Cell Death ◽  
Urothelial Carcinoma ◽  
Prognostic Value ◽  
Multivariable Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Cancer Specific Survival ◽  
Ki 67 ◽  
Upper Tract ◽  
T Stage

We retrospectively enrolled 102 patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy to examine the prognostic value of Ki-67 and programmed cell death ligand-1 (PD-L1). Then, we performed PD-L1 and Ki-67 immunohistochemical staining on whole tissue sections. The cut-off value of PD-L1 positivity was a combined positive score (CPS) ≥10 and the Ki-67 overexpression was 20%. Among the 102 patients, 16.7% and 48.0% showed positive PD-L1 expression and Ki-67 overexpression, respectively. A CPS ≥10 was significantly associated with a higher pathological T stage (p = 0.049). In addition, Ki-67 overexpression was significantly associated with a pathological T stage ≥ 2 (p = 0.027) and tumour necrosis (p = 0.016). In the multivariable analysis, a positive PD-L1 expression was significantly correlated with worse cancer-specific survival (HR = 3.66, 95% CI =1.37−9.77, p = 0.01). However, there was no predictive value using a combination of PD-L1 expression and Ki-67 overexpression as a prognostic predictor. Compared with Ki-67 overexpression, a positive PD-L1 expression with CPS ≥ 10 was a stronger independent prognostic factor for CSS in patients with UTUC.

scholarly journals Trends of incidence and prognosis of upper tract urothelial carcinoma

2020 ◽  
Author(s):  
Jianping Wu ◽  
Shuqiu Chen ◽  
Xiaoli Wu ◽  
Weipu Mao ◽  
Yali Wang ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Cox Regression ◽  
Upper Tract Urothelial Carcinoma ◽  
Downward Trend ◽  
R Software ◽  
Cancer Specific Survival ◽  
Upper Tract ◽  
Good Consistency ◽  
Personalized Risk Assessment ◽  
Personalized Risk

The purpose of this study was to investigate trends in the incidence of upper tract urothelial carcinoma (UTUC) in patients and to establish a reliable and practical nomogram based on significant clinical factors to predict the overall survival (OS) and cancer-specific survival (CSS) of UTUC patients. The Surveillance, Epidemiology, and End Results (SEER) database was used to extract data on UTUC patients between 1988 and 2015. Incidence was calculated using Joinpoint regression software, and trends were quantified by annual percentage change (APC). A nomogram was constructed using R software to predict the OS and CSS probabilities for individual patients. From 1988 to 2015, the incidence of UTUC showed a downward trend (1988: 1.57/100,000 to 2015: 1.51/100,000; APC=-0.1). After stratification according to sex, age and primary site, we found that the incidences of UTUC in males, patients 70+ years old and the renal pelvis were higher than those in females, patients <70 years old and ureter cancer patients. In the training cohort, the nomogram established based on multivariate Cox regression results showed better OS and CSS accuracy (OS: C-index=0.701, AUC=0.736; CSS: C-index=0.729, and AUC=0.688) than SEER stage. In addition, the calibration curves showed good consistency between the predicted and actual 3-, 5- and 10-year OS and CSS rates of the nomogram. In the past 30 years, the incidence of UTUC has shown a general downward trend, and the prognostic nomogram we established can provide a personalized risk assessment for the survival of UTUC patients.

Independent validation of the 2002 UICC TNM staging system for papillary renal cell carcinoma in a multicenter cohort

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5092-5092
Author(s):  
C. Wulfing ◽  
E. Herrmann ◽  
L. Trojan ◽  
A. Schrader ◽  
F. Becker ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Multivariate Analysis ◽  
Metastatic Disease ◽  
Renal Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Staging System ◽  
Tnm Staging ◽  
Cancer Specific Survival ◽  
Tnm Staging System

5092 Background: Papillary renal cell carcinoma (pRCC) is the second most malignant histologic subtype in nephrectomy specimens. To date, the most recognized staging system to stratify renal cancer patients is the 2002 UICC TNM classification system. Its accuracy for predicting patient outcome for pRCC is unknown. Methods: From ten urologic institutions in Germany follow-up data on 675 patients with pRCC were collected. In most cases histologic slides were available and central pathologic review was performed. The Kaplan-Meier method was used to derive the cumulative cancer-specific survival. For multivariate analysis of prognostic factors, a Cox regression analysis was performed. Results: 498 (74.1%) patients had organ-confined tumor stages (≤pT2). Synchronous distant metastases in the entire group occurred in 58 (8.7%) patients and 69 (11.2%) others developed metastatic disease during follow-up. Cancer-specific survival (CSS) was significantly related to TNM stage and histologic grading in univariate as well as in multivariate analysis (all p < 0.0001). 5-year CSS in pT1b tumors (90.0%) was significantly shorter compared to pT1a tumors (98.3%) (p = 0.017). Patients with ≥pT3 were at high risk for metastases (50.6%), while metastatic disease associated with ≤pT2 tumors occurred in 7.8% (p < 0.0001). Once metastatic disease was present, prognosis was poor (5-year CSS: 7.2%). Age was associated with a worse prognosis in the subgroup of ≥pT3 tumors in univariate (p = 0.026), but not in multivariate analysis. Conclusions: The 2002 UICC TNM staging system is applicable for pRCC. Clinical and radiologic follow-ups should be offered in frequent intervals to patients with venous thrombus and/or locally advanced disease. The role of age remains unclear, but should not be underestimated at risk stratification after tumor resection. No significant financial relationships to disclose.

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