PURPOSE: To externally validate the Christodouleas risk model incorporating pathological tumor stage, lymph node (LN) count and soft tissue surgical margin (STSM) and stratifying patients who develop locoregional recurrence (LR) after radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). In addition, we aimed to generate a new model including established clinicopathological features that were absent in the Christodouleas risk model. METHODS: Prospectively assessed multicenter data from 565 patients undergoing RC for UCB in 2011 qualified for final analysis. For the purpose of external validation, risk group stratification according to Christodouleas was performed. Competing-risk models were calculated to compare the cumulative incidences of LR after RC. RESULTS: After a median follow-up of 25 months (interquartile range 19-29), the LR-rate was 11.5 %. The Christodouleas model showed a predictive accuracy of 83.2 % in our cohort. In multivariable competing-risk analysis, tumor stage ≥pT3 (HR 4.32, p < 0.001), positive STSM (HR 2.93, p = 0.005), lymphovascular invasion (HR 3.41, p < 0.001), the number of removed LNs <10 (HR 2.62, p < 0.001) and the administration of adjuvant chemotherapy (HR 0.40, p = 0.008) independently predicted the LR-rate. The resulting risk groups revealed significant differences in LR-rates after 24 months with 4.8 % for low-risk patients, 14.7 % for intermediate-risk patients and 38.9 % for high-risk patients (p < 0.001 for all), with a predictive accuracy of 85.6 %, respectively. CONCLUSIONS: The Christodouleas risk model has been successfully externally validated in the present prospective series. However, this analysis finds that overall model performance may be improved by incorporating lymphovascular invasion. After external validation of the newly proposed risk model, it may be used to identify patients who benefit from an adjuvant therapy and suit for inclusion in clinical trials.
PURPOSE: To externally validate the Christodouleas risk model incorporating pathological tumor stage, lymph node (LN) count and soft tissue surgical margin (STSM) and stratifying patients who develop locoregional recurrence (LR) after radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). In addition, we aimed to generate a new model including established clinicopathological features that were absent in the Christodouleas risk model. METHODS: Prospectively assessed multicenter data from 565 patients undergoing RC for UCB in 2011 qualified for final analysis. For the purpose of external validation, risk group stratification according to Christodouleas was performed. Competing-risk models were calculated to compare the cumulative incidences of LR after RC. RESULTS: After a median follow-up of 25 months (interquartile range 19-29), the LR-rate was 11.5 %. The Christodouleas model showed a predictive accuracy of 83.2 % in our cohort. In multivariable competing-risk analysis, tumor stage ≥pT3 (HR 4.32, p < 0.001), positive STSM (HR 2.93, p = 0.005), lymphovascular invasion (HR 3.41, p < 0.001), the number of removed LNs <10 (HR 2.62, p < 0.001) and the administration of adjuvant chemotherapy (HR 0.40, p = 0.008) independently predicted the LR-rate. The resulting risk groups revealed significant differences in LR-rates after 24 months with 4.8 % for low-risk patients, 14.7 % for intermediate-risk patients and 38.9 % for high-risk patients (p < 0.001 for all), with a predictive accuracy of 85.6 %, respectively. CONCLUSIONS: The Christodouleas risk model has been successfully externally validated in the present prospective series. However, this analysis finds that overall model performance may be improved by incorporating lymphovascular invasion. After external validation of the newly proposed risk model, it may be used to identify patients who benefit from an adjuvant therapy and suit for inclusion in clinical trials.
Authors: Michael Froehner; Vladimir Novotny; Manfred P Wirth; Sabine Brookman-May; Atiqullah Aziz; Matthias May Journal: Cancer Date: 2014-07-12 Impact factor: 6.860
Authors: Giacomo Novara; Robert S Svatek; Pierre I Karakiewicz; Eila Skinner; Vincenzo Ficarra; Yves Fradet; Yair Lotan; Hendrik Isbarn; Umberto Capitanio; Patrick J Bastian; Wassim Kassouf; Hans-Martin Fritsche; Jonathan I Izawa; Derya Tilki; Colin P Dinney; Seth P Lerner; Mark Schoenberg; Bjoern G Volkmer; Arthur I Sagalowsky; Shahrokh F Shariat Journal: J Urol Date: 2010-06 Impact factor: 7.450
Authors: Atiqullah Aziz; Matthias May; Maximilian Burger; Rein-Jüri Palisaar; Quoc-Dien Trinh; Hans-Martin Fritsche; Michael Rink; Felix Chun; Thomas Martini; Christian Bolenz; Roman Mayr; Armin Pycha; Philipp Nuhn; Christian Stief; Vladimir Novotny; Manfred Wirth; Christian Seitz; Joachim Noldus; Christian Gilfrich; Shahrokh F Shariat; Sabine Brookman-May; Patrick J Bastian; Stefan Denzinger; Michael Gierth; Florian Roghmann Journal: Eur Urol Date: 2013-12-27 Impact factor: 20.096
Authors: Michael Rink; Daniel J Lee; Matthew Kent; Evanguelos Xylinas; Hans-Martin Fritsche; Marko Babjuk; Antonin Brisuda; Jens Hansen; David A Green; Atiqullah Aziz; Eugene K Cha; Giacomo Novara; Felix K Chun; Yair Lotan; Patrick J Bastian; Derya Tilki; Paolo Gontero; Armin Pycha; Jack Baniel; Roy Mano; Vincenzo Ficarra; Quoc-Dien Trinh; Scott T Tagawa; Pierre I Karakiewicz; Douglas S Scherr; Daniel D Sjoberg; Shahrokh F Shariat Journal: BJU Int Date: 2012-09-03 Impact factor: 5.588
Authors: Evanguelos Xylinas; Michael Rink; Giacomo Novara; David A Green; Thomas Clozel; Hans-Martin Fritsche; Bertrand Guillonneau; Yair Lotan; Wassim Kassouf; Derya Tilki; Marek Babjuk; Pierre I Karakiewicz; Francesco Montorsi; Joual Abdennabi; Quoc D Trinh; Robert S Svatek; Douglas S Scherr; Marc Zerbib; Shahrokh F Shariat Journal: Ann Surg Oncol Date: 2012-10-26 Impact factor: 5.344
Authors: Mohamed S Zaghloul; John P Christodouleas; Andrew Smith; Ahmed Abdallah; Hany William; Hussein M Khaled; Wei-Ting Hwang; Brian C Baumann Journal: JAMA Surg Date: 2018-01-17 Impact factor: 14.766
Authors: Atiqullah Aziz; Michael Gierth; Michael Rink; Marianne Schmid; Felix K Chun; Roland Dahlem; Florian Roghmann; Rein-Jüri Palisaar; Joachim Noldus; Jörg Ellinger; Stefan C Müller; Armin Pycha; Thomas Martini; Christian Bolenz; Rudolf Moritz; Edwin Herrmann; Bastian Keck; Bernd Wullich; Roman Mayr; Hans-Martin Fritsche; Maximilian Burger; Patrick J Bastian; Christian Seitz; Sabine Brookman-May; Evanguelos Xylinas; Shahrokh F Shariat; Margit Fisch; Matthias May Journal: World J Urol Date: 2015-05-07 Impact factor: 4.226
Authors: Andrea Necchi; Gregory R Pond; Marco Moschini; Elizabeth R Plimack; Gunter Niegisch; Evan Y Yu; Aristotelis Bamias; Neeraj Agarwal; Ulka Vaishampayan; Christine Theodore; Srikala S Sridhar; Jonathan E Rosenberg; Joaquim Bellmunt; Andrea Gallina; Renzo Colombo; Francesco Montorsi; Alberto Briganti; Matthew D Galsky Journal: Clin Genitourin Cancer Date: 2018-09-13 Impact factor: 2.872
Authors: Paul Sargos; Brian C Baumann; Libni J Eapen; Amit Bahl; Vedang Murthy; Guilhem Roubaud; Mathieu Orré; Jason A Efstathiou; Shahrokh Shariat; Stephane Larré; Pierre Richaud; John P Christodouleas Journal: Transl Androl Urol Date: 2016-10
Authors: Brian C Baumann; Paul Sargos; Libni J Eapen; Jason A Efstathiou; Ananya Choudhury; Amit Bahl; Vedang Murthy; Leslie K Ballas; Valérie Fonteyne; Pierre M Richaud; Mohamed S Zaghloul; John P Christodouleas Journal: Bladder Cancer Date: 2017-01-27