Nomograms including nuclear matrix protein 22 for prediction of disease recurrence and progression in patients with Ta, T1 or CIS transitional cell carcinoma of the bladder.

Abstract

PURPOSE:

We developed and validated nomograms that accurately predict disease recurrence and progression in patients with Ta, T1, or CIS transitional cell carcinoma (TCC) of the bladder using a large international cohort.

METHODS:

Univariate and multivariate logistic regression models targeted histologically confirmed disease recurrence, and focused on 2,542 patients with bladder TCC from 10 participating centers. Variables consisted of pre-cystoscopy voided urine Nuclear Matrix Protein 22 (NMP22) assay, urine cytology, age and gender. Resulting nomograms were internally validated with bootstrapping. Nomogram performance was explored graphically with Loess smoothing plots.

RESULTS:

Overall 957 patients had recurrent TCC. Tumor grade and stage was available for 898 patients, including 24% grade I, 43% grade II, and 33% grade III; 45% stage Ta, 32% T1 and/or CIS, and 23% T2 or greater. Bootstrap corrected predictive accuracy for any TCC recurrence was 0.842; grade III Ta/T1 or CIS was 0.869; and T2 or higher stage TCC of any grade was 0.858. Virtually perfect performance characteristics were observed for the nomograms predicting any TCC recurrence or grade III Ta/T1 or CIS. The nomogram predicting T2 or higher stage TCC overestimated the observed probability for predicted values greater than 45%.

CONCLUSIONS:

We developed and internally validated nomograms that incorporate urinary NMP22, cytology, age and gender to predict with high accuracy the probability of disease recurrence and progression in patients with Ta, T1, and/or CIS bladder TCC. These nomograms could provide a means for individualizing followup in patients with Ta, T1, CIS bladder TCC.

• Authors: Shahrokh F Shariat, Craig Zippe, Gerson Lüdecke, Hans Boman, Marta Sanchez-Carbayo, Roberto Casella, Christine Mian, Martin G Friedrich, Sanaa Eissa, Hideyuki Akaza, Ihor Sawczuk, Vincenzo Serretta, Hartwig Huland, Hans Hedelin, Raina Rupesh, Naoto Miyanaga, Arthur I Sagalowsky, Frank Wians Jr, Claus G Roehrborn, Yair Lotan, Paul Perrotte, Serge Benayoun, Michael J Marberger, Pierre I Karakiewicz
• Journal: The Journal of urology (J Urol) Vol. 173 Issue 5 Pg. 1518-25 (May 2005) ISSN: 0022-5347 [Print] United States
• PMID: 15821471 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, Validation Study)

Chemical References

• Biomarkers, Tumor
• Nuclear Proteins
• nuclear matrix protein 22

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (urine)
• Carcinoma, Transitional Cell (pathology, urine)
• Disease Progression
• Female
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Staging
• Nomograms
• Nuclear Proteins (urine)
• Prognosis
• Urinary Bladder Neoplasms (pathology, urine)