J Korean Med Sci.  2008 Jun;23(3):428-433. 10.3346/jkms.2008.23.3.428.

Nomograms for Prediction of Disease Recurrence in Patients with Primary Ta, T1 Transitional Cell Carcinoma of the Bladder

• Hong SJ
• Cho KS
• Han M
• Rhew HY
• Kim CS
• Ryu SB
• Sul CK
• Chung MK
• Park TC
• Kim HJ
• The Korean Urological Oncology Society

• KMID: 1786880
• DOI: http://doi.org/10.3346/jkms.2008.23.3.428

Abstract

We developed nomograms to predict disease recurrence in patients with Ta, T1 transitional cell carcinoma of the bladder. Thirty-eight training hospitals participated in this retrospective multicenter study. Between 1998 and 2002, a total of 1,587 patients with newly diagnosed non-muscle invasive bladder cancer were enrolled in this study. Patients with prior histories of bladder cancer, non-transitional cell carcinoma, or a follow-up duration of less than 12 months were excluded. With univariate and multivariate logistic regression analyses, we constructed nomograms to predict disease recurrence, and internal validation was performed using statistical techniques. Three-year and five-year recurrence-free rates were 64.3% and 55.3%, respectively. Multivariate analysis revealed that age (hazard ratio [HR]=1.437, p<0.001), tumor size (HR=1.328, p=0.001), multiplicity (HR=1.505, p<0.001), tumor grade (HR=1.347, p=0.007), concomitant carcinoma in situ (HR=1.611, p=0.007), and intravesical therapy (HR=0.681, p<0.001) were independent predictors for disease recurrence. Based on these prognostic factors, nomograms for the prediction of disease recurrence were developed. These nomograms can be used to predict the probability of disease recurrence in patients with newly diagnosed Ta, T1 transitional cell carcinoma of the bladder. They may be useful for patient counseling, clinical trial design, and patient follow-up planning.

Keyword

Carcinoma, Transitional Cell; Urinary Bladder; Recurrence; Nomograms

MeSH Terms

Aged
Carcinoma in Situ/diagnosis/epidemiology
Carcinoma, Transitional Cell/*diagnosis/*epidemiology
Disease-Free Survival
Female
Humans
Male
Multivariate Analysis
*Nomograms
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Recurrence
Regression Analysis
Reproducibility of Results
Urinary Bladder Neoplasms/*diagnosis/*epidemiology

Figure

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  Fig. 1 Overall recurrence-free probability.

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  Fig. 2 Nomograms to predict first recurrence at three years (A) and at five years (B).

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