Substratification of patients with highest‐risk non‐muscle invasive bladder cancer helps to identify the candidates for immediate radical cystectomy: A two‐center study
| العنوان: | Substratification of patients with highest‐risk non‐muscle invasive bladder cancer helps to identify the candidates for immediate radical cystectomy: A two‐center study |
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| المؤلفون: | Tao Yang, Hua Liang, Xinqi Pei, Nan Zhang, Xiao Liang, Mengzhao Zhang, Qiuya Shao, Lu Wang, Minghai Ma, Xinyu Shi, Jinhai Fan |
| المصدر: | International Journal of Urology. 29:930-936 |
| بيانات النشر: | Wiley, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Carcinoma, Transitional Cell, Urinary Bladder Neoplasms, Urology, Urinary Bladder, Humans, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Cystectomy, Neoplasm Staging, Retrospective Studies |
| الوصف: | Performing immediate radical cystectomy in all patients with the highest-risk non-muscle invasive bladder cancer results in overtreatment. We confirm whether the substratification of highest-risk patients can more effectively select suitable patients for radical cystectomy.Patients with primary T1 high grade bladder cancer from two centers were included and roughly stratified into high-risk or highest-risk. The highest-risk patients were further substratified according to the number of risk factors. Endpoints were tumor recurrence and progression. The predictive accuracy was assessed with internal validation that consists of time-dependent receiver operating characteristic curve and calibration curves.A total of 262 patients were included. Although highest-risk patient had a poor prognosis, after further substratification, we found that those with only one factor showed the same prognosis with high-risk patients (recurrence: hazard ratio 1.79, P = 0.105; progression: hazard ratio 1.38, P = 0.532), while those with ≥2 factors had worst prognosis than high-risk patients. The 3-year area under the curve showed that the predictive accuracy of substratification in terms of recurrence and progression were superior to that of non-substratification (0.685 vs 0.622 and 0.666 vs 0.599, respectively). Additionally, calibration curves showed perfect agreement between the predicted and the actual recurrence and progression.Substratification of highest-risk enables us to further optimize the surgical decisions-making. Highest-risk patients with one factor show the similar outcomes as high-risk patients and deserve to try bladder-sparing treatment, whereas those with ≥2 risk factors were strongly recommended to undergo radical cystectomy. |
| تدمد: | 1442-2042 0919-8172 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8fbb093ca563f90fd4c177c8896df600 https://doi.org/10.1111/iju.14808 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....8fbb093ca563f90fd4c177c8896df600 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14422042 09198172 |
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