SUO 2017: Cancer And All-cause Mortality In Bladder Cancer Patients Undergoing Radical Cystectomy: Development And Validation Of A Nomogram For Treatment Decision-making

Washington, DC ( This study aimed to develop and validate a nomogram assessing cancer specific and all-cause mortality following radical cystectomy (RC).

A total of 5,325 and 1,257 patients diagnosed with clinical stage T2-T4a muscle-invasive bladder cancer from January 1, 2006 to December 31, 2011 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare and Texas Cancer Registry (TCR)- Medicare linked-data, respectively, were included in this study. Cox proportional hazards models were used and a nomogram was developed to predict 3- and 5-year overall and cancer-specific survival with external validation.

Patients who underwent RC were more likely to have been younger, male, married, non-Hispanic white, and to have had fewer comorbidities than those who did not undergo RC (p<0.001). Married patients, in comparison to their unmarried counterparts, had both improved overall (Hazard Ratio (HR) 0.76= 95% CI 0.70 to 0.83, p<0.001) and cancer-specific (HR 0.76= 95% CI 0.68 to 0.85, p<0.001) survival. A nomogram developed using SEER-Medicare data, predicted 3- and 5-year overall and cancer-specific survival rates with concordance indices of 0.65 and 0.66 in the validated TCR-Medicare cohort, respectively.

Older, unmarried patients with more comorbidities are less likely to undergo RC. The authors claim to have developed and validated a generalizable instrument which has been converted into an on-line tool (Radical Cystectomy Survival Calculator© (RCSC)), to provide a benefit-risk assessment for patients considering RC.

Presented by: Tamer Dafashy, Division of Urology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC