BACKGROUND: The current study was conducted to develop a pretreatment prognostic model for patients with unresectable and/or metastatic urothelial cancer who were treated with first-line, cisplatin-based chemotherapy. METHODS: Individual data were pooled from 399 patients who were enrolled on 8 phase 2 and 3 trials evaluating cisplatin-based, first-line chemotherapy in patients with metastatic urothelial carcinoma. Variables selected for inclusion in the model were combined in a Cox proportional hazards model to produce a points-based nomogram with which to predict the median, 1-year, 2-year, and 5-year survival. The nomogram was validated externally using data from a randomized trial of the combination of methotrexate, vinblastine, doxorubicin plus cisplatin versus docetaxel plus cisplatin. RESULTS: The median survival of the development cohort was 13.8 months (95% confidence interval, 12.1 months-16.0 months); 68.2% of the patients had died at the time of last follow-up. On multivariable analysis, the number of visceral metastatic sites, Eastern Cooperative Oncology Group performance status, and leukocyte count were each found to be associated with overall survival (P < .05), whereas the site of the primary tumor and the presence of lymph node metastases were not. All 5 variables were included in the nomogram. When subjected to internal validation, the nomogram achieved a bootstrap-corrected concordance index of 0.626. When applied to the external validation cohort, the nomogram achieved a concordance index of 0.634. Calibration plots suggested that the nomogram was well calibrated for all predictions. CONCLUSIONS: Based on routinely measured pretreatment variables, a nomogram was constructed that predicts survival in patients with unresectable and/or metastatic urothelial cancer who are treated with cisplatin-based chemotherapy. This model may be useful in patient counseling and clinical trial design.
BACKGROUND: The current study was conducted to develop a pretreatment prognostic model for patients with unresectable and/or metastatic urothelial cancer who were treated with first-line, cisplatin-based chemotherapy. METHODS: Individual data were pooled from 399 patients who were enrolled on 8 phase 2 and 3 trials evaluating cisplatin-based, first-line chemotherapy in patients with metastatic urothelial carcinoma. Variables selected for inclusion in the model were combined in a Cox proportional hazards model to produce a points-based nomogram with which to predict the median, 1-year, 2-year, and 5-year survival. The nomogram was validated externally using data from a randomized trial of the combination of methotrexate, vinblastine, doxorubicin plus cisplatin versus docetaxel plus cisplatin. RESULTS: The median survival of the development cohort was 13.8 months (95% confidence interval, 12.1 months-16.0 months); 68.2% of the patients had died at the time of last follow-up. On multivariable analysis, the number of visceral metastatic sites, Eastern Cooperative Oncology Group performance status, and leukocyte count were each found to be associated with overall survival (P < .05), whereas the site of the primary tumor and the presence of lymph node metastases were not. All 5 variables were included in the nomogram. When subjected to internal validation, the nomogram achieved a bootstrap-corrected concordance index of 0.626. When applied to the external validation cohort, the nomogram achieved a concordance index of 0.634. Calibration plots suggested that the nomogram was well calibrated for all predictions. CONCLUSIONS: Based on routinely measured pretreatment variables, a nomogram was constructed that predicts survival in patients with unresectable and/or metastatic urothelial cancer who are treated with cisplatin-based chemotherapy. This model may be useful in patient counseling and clinical trial design.
Authors: Guru Sonpavde; Gregory R Pond; Jonathan E Rosenberg; Dean F Bajorin; Toni K Choueiri; Andrea Necchi; Giuseppe Di Lorenzo; Joaquim Bellmunt Journal: J Urol Date: 2015-08-17 Impact factor: 7.450
Authors: Andrea Necchi; Gregory R Pond; Patrizia Giannatempo; Giuseppe Di Lorenzo; Bernhard J Eigl; Jenn Locke; Sumanta K Pal; Neeraj Agarwal; Austin Poole; Ulka N Vaishampayan; Guenter Niegisch; Syed A Hussain; Parminder Singh; Joaquim Bellmunt; Guru Sonpavde Journal: Clin Genitourin Cancer Date: 2014-09-23 Impact factor: 2.872
Authors: Jacqueline T Brown; Yuan Liu; Julie M Shabto; Dylan J Martini; Deepak Ravindranathan; Emilie Elise Hitron; Greta Anne Russler; Sarah Caulfield; Lauren Beth Yantorni; Shreyas S Joshi; Haydn Kissick; Kenneth Ogan; Wayne B Harris; Bradley C Carthon; Omer Kucuk; Viraj A Master; Mehmet Asim Bilen Journal: Oncologist Date: 2021-03-18
Authors: Andrea Necchi; Guru Sonpavde; Salvatore Lo Vullo; Daniele Giardiello; Aristotelis Bamias; Simon J Crabb; Lauren C Harshman; Joaquim Bellmunt; Ugo De Giorgi; Cora N Sternberg; Linda Cerbone; Sylvain Ladoire; Yu-Ning Wong; Evan Y Yu; Simon Chowdhury; Gunter Niegisch; Sandy Srinivas; Ulka N Vaishampayan; Sumanta K Pal; Neeraj Agarwal; Ajjai Alva; Jack Baniel; Ali-Reza Golshayan; Rafael Morales-Barrera; Daniel W Bowles; Matthew I Milowsky; Christine Theodore; Dominik R Berthold; Gedske Daugaard; Srikala S Sridhar; Thomas Powles; Jonathan E Rosenberg; Matthew D Galsky; Luigi Mariani Journal: Eur Urol Date: 2016-10-08 Impact factor: 20.096
Authors: Roger Li; Janet E Baack Kukreja; Mohamed A Seif; Firas G Petros; Matthew T Campbell; Justin V Nguyen; Graciela M Nogueras González; Ashish M Kamat; Louis L Pisters; Colin P Dinney; Neema Navai Journal: World J Urol Date: 2019-03-12 Impact factor: 4.226
Authors: Sumanta Kumar Pal; Yulan Ingrid Lin; Bertram Yuh; Kara DeWalt; Austin Kazarian; Nicholas Vogelzang; Rebecca A Nelson Journal: PLoS One Date: 2015-08-26 Impact factor: 3.240
Authors: Andrea Necchi; Gregory R Pond; Sumanta K Pal; Neeraj Agarwal; Daniel W Bowles; Elizabeth R Plimack; Evan Y Yu; Sylvain Ladoire; Jack Baniel; Simon Crabb; Gunter Niegisch; Sandy Srinivas; Dominik R Berthold; Jonathan E Rosenberg; Thomas Powles; Aristotelis Bamias; Lauren C Harshman; Joaquim Bellmunt; Matthew D Galsky Journal: Clin Genitourin Cancer Date: 2017-11-01 Impact factor: 2.872