A Systematic Review and Meta-Analysis of Prognostic Nomograms After UTUC Surgery

Pallauf, Maximilian; König, Frederik; D’Andrea, David; Laukhtina, Ekaterina; Mostafaei, Hadi; Motlagh, Reza Sari; Quhal, Fahad; Aydh, Abdulmajeed; Yanagisawa, Takafumi; Kawada, Tatsushi; Rajwa, Paweł; Lusuardi, Lukas; Soria, Francesco; Karakiewicz, Pierre I.; Rouprêt, Morgan; Rink, Michael; Lotan, Yair; Margulis, Vitaly; Singla, Nirmish; Xylinas, Évanguelos; Shariat, Shahrokh F.; Pradère, Benjamin

doi:10.3389/fonc.2022.907975

Cited by 10 publications

(9 citation statements)

References 63 publications

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“…In addition, to our best knowledge, there is no fall risk assessment scale that specifically targets the elderly with visual impairment to highlight the high-risk groups. Prediction models and nomograms based on predictors/risk factors of diseases can provide patients with accurate prediction tools to be used in safety management for individuals ( 43 – 45 ). We contributed a predictive model and nomogram based on these abovementioned risk factors for falls, and older patients with visual impairment may get a predicted probability of fall based on the total score axis of the nomogram.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of falls in elderly patients with visual impairment

Ouyang

Zheng

Lin

et al. 2022

Front. Public Health

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ObjectiveTo examine the risk factors for falls in elderly patients with visual impairment (VI) and assess the predictive performance of these factors.MethodsBetween January 2019 and March 2021, a total of 251 elderly patients aged 65–92 years with VI were enrolled and then prospectively followed up for 12 months to evaluate outcomes of accidental falls via telephone interviews. Information of demographics and lifestyle, gait and balance deficits, and ophthalmic and systemic conditions were collected during baseline visits. Forward stepwise multivariable logistic regression analysis was performed to identify independent risk factors of falls in elderly patients with VI, and a derived nomogram was constructed.ResultsA total of 143 falls were reported in 251 elderly patients during follow-up, with an incidence of 56.97%. The risk factors for falls in elderly patients with VI identified by multivariable logistic regression were women [odds ratio (OR), 95% confidence interval (CI): 2.71, 1.40–5.27], smoking (3.57, 1.34–9.48), outdoor activities/3 months (1.31, 1.08–1.59), waking up frequently during the night (2.08, 1.15–3.79), disorders of balance and gait (2.60, 1.29–5.24), glaucoma (3.12, 1.15–8.44), other retinal degenerations (3.31, 1.16–9.43) and best-corrected visual acuity (BCVA) of the better eye (1.79, 1.10–2.91). A nomogram was developed based on the abovementioned multivariate analysis results. The area under receiver operating characteristic curve of the predictive model was 0.779.ConclusionsGender, smoking, outdoor activities, waking up at night, disorders of balance and gait, glaucoma, other retinal degeneration and BCVA of the better eye were independent risk factors for falls in elderly patients with VI. The predictive model and derived nomogram achieved a satisfying prediction of fall risk in these individuals.

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Section: Discussionmentioning

confidence: 99%

Risk factors of falls in elderly patients with visual impairment

Ouyang

Zheng

Lin

et al. 2022

Front. Public Health

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“…Current risk stratification for UTUC is based on clinical and pathologic features [ 1 ]. However, these models suffer from moderate discrimination and a lack of external validation [ 24 ]. Discovery of clinically useful biomarkers and their addition to current predictive models is the new frontier in the era of personalized medicine.…”

Section: Discussionmentioning

confidence: 99%

Clinical value of cholinesterase in patients treated with radical nephroureterectomy for upper urinary tract carcinoma

et al. 2023

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Purpose To evaluate the prognostic value and the clinical impact of preoperative serum cholinesterase (ChoE) levels on decision-making in patients treated with radical nephroureterectomy (RNU) for clinically non-metastatic upper tract urothelial cancer (UTUC). Methods A retrospective review of an established multi-institutional UTUC database was performed. We evaluated preoperative ChoE as a continuous and dichotomized variable using a visual assessment of the functional form of the association of ChoE with cancer-specific survival (CSS). We used univariable and multivariable Cox regression models to establish its association with recurrence-free survival (RFS), CSS, and overall survival (OS). Discrimination was evaluated using Harrell’s concordance index. Decision curve analysis (DCA) was used to assess the impact on clinical decision-making of preoperative ChoE. Results A total of 748 patients were available for analysis. Within a median follow-up of 34 months (IQR 15–64), 191 patients experienced disease recurrence, and 257 died, with 165 dying of UTUC. The optimal ChoE cutoff identified was 5.8 U/l. ChoE as continuous variable was significantly associated with RFS (p < 0.001), OS (p < 0.001), and CSS (p < 0.001) on univariable and multivariable analyses. The concordance index improved by 8%, 4.4%, and 7% for RFS, OS, and CSS, respectively. On DCA, including ChoE did not improve the net benefit of standard prognostic models. Conclusion Despite its independent association with RFS, OS, and CSS, preoperative serum ChoE has no impact on clinical decision-making. In future studies, ChoE should be investigated as part of the tumor microenvironment and assessed as part of predictive and prognostic models, specifically in the setting of immune checkpoint-inhibitor therapy.

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“…Furthermore, as updated recent multicenter study by ROBUUST group ( 31 ), robotic and laparoscopic surgery group showed comparable oncological outcomes. Recent systemic review and meta-analysis demonstrate that advanced tumor stage and lymphovascular invasion as the most prognostic factor for overall survival ( 32 ). Our cohort also showed consistent result, and we additionally found that B2-MG could be a novel prognostic factor having the comparable prognostic power with above two factors.…”

Section: Discussionmentioning

confidence: 99%

Increased urinary B2-microglobulin is associated with poor prognosis of upper tract urothelial carcinoma

et al. 2022

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BackgroundKidney tubular damage markers are biomarkers of acute or chronic kidney injury. Hypothetically, upper tract urothelial cancer (UTUC), which induces obstructive uropathy or direct invasion of the renal parenchyma, may also induce increased excretion of urinary tubular damage proteins. Therefore, this study aimed to investigate the use of tubular damage biomarker as prognostic markers for UTUC.MethodsThe records of 417 surgically resected patients with UTUC were obtained from the Seoul National University Prospectively Enrolled Registry for urothelial cancer-upper tract urothelial cancer (SUPER-UC-UTUC) between January 2016 and December 2020. Patients with non-urothelial cancer or without urinary tubular injury marker measurement were excluded, and finally, 296 patients were finally included. B2-microglobulin (B2-MG) was an injury marker, and a value higher than 0.3 was considered abnormally elevated, according to previous studies.ResultsThe mean age was 70.9 years, and the male sex was predominant (n = 211, 71.3%). The incidences of renal pelvis and ureter cancer were similar (50.7% vs. 49.3%). Most patients had high-grade diseases (n = 254, 88.8%). The high urine B2-MG group was older, had decreased renal function, and had a higher pathologic T stage than did the low group. Multivariate Cox regression analysis of disease-free survival (DFS), open surgical method (Hazard ratio (HR) 1.52, p = 0.027), large tumor size (HR 1.06, p = 0.017), tumor multifocality (HR 1.90, p = 0.038), lymphovascular invasion (HR 2.19, p < 0.001), and high urine B2-MG (HR 1.57, p = 0.021) were significantly associated with shortened metastasis-free survival (MFS). Kaplan–Meier curve analysis revealed short DFS (median survival 15.5 months vs. unattained, log-rank p = 0.001) and MFS (unattained median survival in both groups, log-rank p = 0.003) for the high urine B2-MG group compared to the low urine B2-MG group.ConclusionPatients with UTUC presenting with increased pre-operative urine B2-MG levels were associated with disease recurrence and metastasis. This biomarker may aid in performing pre-operative risk stratification and in assessing the individual prognosis of patients with UTUC.

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A Systematic Review and Meta-Analysis of Prognostic Nomograms After UTUC Surgery

Cited by 10 publications

References 63 publications

Risk factors of falls in elderly patients with visual impairment

Risk factors of falls in elderly patients with visual impairment

Clinical value of cholinesterase in patients treated with radical nephroureterectomy for upper urinary tract carcinoma

Increased urinary B2-microglobulin is associated with poor prognosis of upper tract urothelial carcinoma

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