Jimeng Ruan, Miaomiao Wang, Xiangyu Wang, Weisi Xing, Meiyuan Chen, Xin Tong and Jing Xiao*
Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR ChinaFulltext PDF
Objective: To identify the risk factors for recurrence and establish a nomogram to predict Relapse- Free Survival (RFS) in patients with Upper Tract Urothelial Carcinoma (UTUC) after Radical Nephroureterectomy (RNU) combined with chemotherapy. Methods: A retrospective analysis was conducted to identify the risk factors for recurrence of the 101 UTUC patients who underwent RNU and bladder cuff resection combined with chemotherapy. Overall Survival (OS) and RFS were assessed using the Kaplan-Meier method. Cox regression model was used to identify risk factors for survival outcomes. The nomogram was developed to predict RFS at 1, 3 and 5-years, after RNU combined with chemotherapy. The performance of the nomogram was evaluated by the concordance index (C-index) and the Receiver Operating Characteristic (ROC) curve. Results: Of the 101 UTUC patients, 40 (39.6%) experienced tumor recurrence, including 32 at bladder and 8 at the contralateral upper urinary tract. The multivariate Cox regression analysis showed that hydronephrosis, T stage, Neoadjuvant Chemotherapy (NAC), chemotherapy cycle and Lymphovascular Invasion (LVI) were the independent risk factors for UTUC recurrence. A nomogram was developed by employing these five predictive factors. For RFS predictions, the C-index value of the nomogram was 0.791. The areas under the curve (AUCROC) of the nomogram were 0.853, 0.893 and 0.903 respectively. Conclusion: Hydronephrosis, T stage, NAC, chemotherapy cycle and LVI are shown to be independent factors for affecting the recurrence of UTUC patients. The nomogram is a simple-touse tool for physicians to facilitate postoperative personalized prognostic evaluation and determine therapeutic strategies for UTUC patients.
Upper tract urothelial carcinoma; Radical nephroureterectomy; Intravenous chemotherapy; Recurrence; Nomogram
Ruan J, Wang M, Wang X, Xing W, Chen M, Tong X, et al. Postoperative Nomogram for Predicting Relapse- Free Survival after Radical Nephroureterectomy Combined with Chemotherapy in Patients with Upper Tract Urothelial Carcinoma. Ann Urol Res. 2020; 4(1): 1020..