NOMOGRAMS INCLUDING NUCLEAR MATRIX PROTEIN 22 FOR PREDICTION OF DISEASE RECURRENCE AND PROGRESSION IN PATIENTS WITH Ta, T1 OR CIS TRANSITIONAL CELL CARCINOMA OF THE BLADDER

Abstract

We developed and internally validated nomograms that incorporate urinary NMP22, cytology, age and gender to predict with high accuracy the probability of disease recurrence and progression in patients with Ta, T1, and/or CIS bladder TCC. These nomograms could provide a means for individualizing followup in patients with Ta, T1, CIS bladder TCC.

Precystectomy Nomogram for Prediction of Advanced Bladder Cancer Stage

“…The above findings indicate that, like other predictive models, the two proposed nomograms are limited by suboptimal accuracy [15][16][17][18][19]. Although the nomograms are not perfect, should they be used?…”

“…For example, Sylvester et al [15] reported a coding scheme designed to predict the probability of recurrence and progression in patients with noninvasive bladder cancer; their recurrence model was 66% accurate and their progression model was 74-75% accurate. Shariat et al [16] also addressed prediction of recurrence in patients with nonmuscle invasive TCC, reporting 75% accuracy without biomarkers and 81% with NMP22. Thus, novel disease markers are clearly needed to improve the current ability to predict bladder cancer stage and biology.…”

“…And if not, what is the alternative? As indicated by journal citations [15][16][17][18][19], suboptimal predictive and prognostic models are reported and used, based on the contention that in absence of perfectly accurate models it is better to predict with a systematic rule, with known accuracy and performance characteristics, than to predict in a less accurate and possibly haphazard fashion. In a direct comparison, Specht et al [20] confirmed the contention that even imperfect nomograms (72%) are better than expert-clinician ratings (54%).…”

Cálculo del riesgo biológico de multirrecidiva y progresión del carcinoma urotelial no músculo-invasivo mediante nuevos modelos matemáticos

“…Se trata de una hipotética variable que bien no ha sido evaluada o bien se desconoce su valor. Una de las posibles variable fragilidad serían los marcadores tumorales [29] o bien ciertas mutaciones genéticas [30]. La inclusión de estas variables podría incrementar la predictibilidad de los modelos de progresión y recidiva múltiple.…”

Differences in Tumor Characteristics and Prognosis in Newly Diagnosed Ta, T1 Urothelial Carcinoma of Bladder According to Patient Age

“…These nomograms also included age as an important determinant, as well as urinary nuclear matrix protein 22, sex, and cytologic findings. 14 The differences in clinical and pathologic features such as multiplicity, tumor size, T category, and prognosis can be explained by patient and medical provider social influences. For example, the diagnosis might be delayed and less-aggressive therapy offered to, and selected by, elderly patients.…”