Postoperative nomogram predicting risk of recurrence after radical cystectomy for bladder cancer

Bernard H. Bochner, Guido Dalbagni, Michael W. Kattan, Paul Fearn, Kinjal Vora, Song Seo Hee, Lauren Zoref, Hassan Abol-Enein, Mohamed A. Ghoneim, Peter T. Scardino, Dean Bajorin, Donald G. Skinner, John P. Stein, Gus Miranda, Jürgen E. Gschwend, Bjoern G. Volkmer, Richard E. Hautmann, Sam Chang, Michael Cookson, Joseph A. SmithGeorge Thalman, Urs E. Studer, Cheryl T. Lee, James Montie, David Wood, Juan Palou, Yyes Fradet, Louis LaCombe, Pierre Simard, Mark P. Schoenberg, Seth Lerner, Amnon Vazina, Pier Francesco Bassi, Masaru Murai, Eiji Kikuchi

Research output: Contribution to journalArticlepeer-review

335 Scopus citations


Purpose: Radical cystectomy and pelvic lymphadenectomy (PLND) remains the standard treatment for localized and regionally advanced invasive bladder cancers. We have constructed an international bladder cancer database from centers of excellence in the management of bladder cancer consisting of patients treated with radical cystectomy and PLND. The goal of this study was the development of a prognostic outcomes nomogram to predict the 5-year disease recurrence risk after radical cystectomy. Patients and Methods: Institutional radical cystectomy databases containing detailed information on bladder cancer patients were obtained from 12 centers of excellence worldwide. Data were collected on more than 9,000 postoperative patients and combined into a relational database formatted with patient characteristics, pathologic details of the pre- and postcystectomy specimens, and recurrence and survival status. Patients with available information for all selected study criteria were included in the formation of the final prognostic nomogram designed to predict 5-year progression-free probability. Results: The final nomogram included information on patient age, sex, time from diagnosis to surgery, pathologic tumor stage and grade, tumor histologic subtype, and regional lymph node status. The predictive accuracy of the constructed international nomogram (concordance index, 0.75) was significantly better than standard American Joint Committee on Cancer TNM (concordance index, 0.68; P < .001) or standard pathologic subgroupings (concordance index, 0.62; P < .001). Conclusion: We have developed an international bladder cancer nomogram predicting recurrence risk after radical cystectomy for bladder cancer. The nomogram outperformed prognostic models that use standard pathologic subgroupings and should improve our ability to provide accurate risk assessments to patients after the surgical management of bladder cancer.

Original languageEnglish (US)
Pages (from-to)3967-3972
Number of pages6
JournalJournal of Clinical Oncology
Issue number24
StatePublished - Aug 20 2006
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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