Prognostic value of site-specific metastases and therapeutic roles of surgery for patients with metastatic bladder cancer: a population-based study

Fan, Daiming; Shen, Yifan; Gao, Feng‐Juan; Xu, Tianmin; Wang, Xianjin; Zhang, Xiaohua; Zhong, Shan; Zhang, Minguang; Chen, Shanwen; Zhang, Shen

doi:10.2147/cmar.s148856

Cited by 45 publications

(43 citation statements)

References 34 publications

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“…The 2018 NCCN guidelines also suggested platinum-based chemotherapy has been standard of care in patients with metastatic disease, with an OS of 9 to 15 months (27). A previous study suggested that different distant-metastatic site and multiple sites metastasis were independent prognostic factors for OS in metastatic BC patients (28), which was consistent with our findings. As shown in nomogram, metastasis pattern was the second large contributor to prognosis.…”

Section: Discussionsupporting

confidence: 90%

Marital Status and Prognostic Nomogram for Bladder Cancer With Distant Metastasis: A SEER-Based Study

et al. 2020

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Background: To investigate the impact of marital status on overall survival (OS) and create a prognostic nomogram predicting OS in distant-metastatic bladder cancer (DMBC) patients. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was explored to recruit DMBC patients from 2010 to 2015. Kaplan-Meier survival analysis was used to compare survival differences among different marital status. Univariate and multivariate analyses were used to screen for prognostic factors and then constructed the nomogram based on Cox proportional hazard regression models. Calibration plot diagrams and concordance index (C-index) were used to verify the prognostic nomogram. Results: Kaplan-Meier curves suggested the significant differences of OS among different marital status existed in total (P < 0.001), female (P = 0.011) and male (P = 0.001) DMBC patients, respectively. Multivariate analysis indicated marital status was an independent prognostic factor for OS of DMBC patients. Nomogram showed the contribution of marital status to predicting OS was small. Other independent prognostic factors included age, grade, histology type, surgery of primary site, chemotherapy, and metastasis pattern. By combining seven factors, we constructed a prognostic nomogram for DMBC patients. The C-index of this nomogram for OS prediction was 0.722 (95% CI 0.712-0.732). The calibration curves showed perfect consistency between observed and predictive survival. Conclusions: Marital status was an independent prognostic factor for OS of DMBC patients, but its contribution to predicting OS was small. The prognostic nomogram will provide an individualized evaluation of OS and guidance for suitable treatments in DMBC patients.

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Section: Discussionsupporting

confidence: 90%

Marital Status and Prognostic Nomogram for Bladder Cancer With Distant Metastasis: A SEER-Based Study

et al. 2020

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“…Hence, we established a novel nomogroup system based on the scores of the nomogram and further proved that the new-established nomogroup could easily divided patients into different risk stratifications. Third, enlightened by one of our previous study 49 , we for the first time revealed that in SCCB patients, distant lymph node metastasis represented better survival outcomes compared with other organ metastases. Hence, in the “metastasis” item of the nomograms, we creatively divided it into four categories (M0; distant node only; other organs; distant node & other organs), which increased the predictive accuracy.…”

Section: Discussionmentioning

confidence: 78%

Nomograms to Predict Individual Prognosis of Patients with Primary Small Cell Carcinoma of the Bladder

Fan¹,

Shen²,

Gao³

et al. 2018

J. Cancer

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Objectives: To develop reliable nomograms to estimate individualized overall survival (OS) and cancer specific survival (CSS) for patients with primary small cell carcinoma of the bladder (SCCB) and compare the predictive value with the AJCC stages.Patients and Methods: 582 eligible SCCB patients identified in the Surveillance, Epidemiology, and End Results (SEER) dataset were randomly divided into training (n=482) and validation (n=100) cohorts. Akaike information criterion was used to select the clinically important variables in multivariate Cox models when establishing nomograms. The performance of nomograms was bootstrapped validated internally and externally using the concordance index (C-index) with 95% confidence interval (95% CI) and calibration curves and was compared with that of the AJCC stages using C-index, Kaplan-Meier curves and decision curve analysis (DCA).Results: Two nomograms shared common indicators including age, tumor size, T stage, lymph node ratio, metastases, chemotherapy, radiation and radical cystectomy, while marriage and gender were only incorporated in the OS nomogram. The C-indices of nomograms for OS and CSS were 0.736 (95%CI 0.711-0.761) and 0.731(95%CI 0.704-0.758), respectively, indicating considerable predictive accuracy. Calibration curves showed consistency between the nomograms and the actual observation. The results remained reproducible when nomograms were applied to the validation cohort. Additionally, comparisons between C-indices, Kaplan-Meier curves and DCA proved that the nomograms obtained obvious superiority over the AJCC stages with wide practical threshold probabilities.Conclusions: We proposed the first two nomograms for individualized prediction of OS and CSS in SCCB patients with satisfactory predictive accuracy, good robustness and wide applicability.

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“…Patients with metastatic BC generally have a poor prognosis, surviving just a few months because of the ease with which it invades the muscle layer 3. In previous studies, approximately 10-15% of BC patients were reported to present at diagnosis with metastatic disease 4,5. Bone metastases (BM) were reported to be correlated with skeletal complications and decrease survival and quality of life in urogenital neoplasms patients 6-8.…”

Section: Introductionmentioning

confidence: 99%

“…It is widely accepted that early diagnosis of BM from BC could benefit from timely medical intervention and skeletal-related events (SREs) prevention 4,7. Currently, there are no screening guidelines for performance of routine evaluation of BM in BC patients.…”

Section: Introductionmentioning

confidence: 99%

Bone Metastases Pattern in Newly Diagnosed Metastatic Bladder Cancer: A Population-Based Study

Zhang¹,

Liu²,

Fang³

et al. 2018

J. Cancer

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Purpose: Based on a large-population analysis, we aimed to estimate the incidence and survival of bone metastases (BM) in initial bladder cancer (BC) patients and to identify the risk and prognostic factors of BC patients with BM.Patients and methods: Using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, bladder cancer patients diagnosed between 2010 and 2014 were retrieved. Multivariate logistic and Cox regression analyses were employed to identify risk factors and prognostic factors for BM in BC patients. A Kaplan-Meier analysis with log-rank test was used to estimate the overall survival for BC and the difference between the survival curves.Results: A total of 1,223 (1.39%) BC patients were diagnosed with de novo BM. Variables such as age between 41 to 60 years, black race, unmarried status, higher T stage, higher N stage, poor tumour differentiation grade, lung metastases, liver metastases, and brain metastases were positively associated with BM occurrence. The median survival for BC patients with BM was dramatically decreased to 4.0 months. Factors including advanced age, absence of surgery, and presence of lung, liver, or brain metastases all predicted worse survival.Conclusion: BM can dramatically decrease the survival of bladder cancer patients. The findings of the present study can provide population-based identification of risk and prognostic factors for BC patients with BM at initial diagnosis, which can be used for BM occurrence prediction and individualized treatment plan-making.

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Prognostic value of site-specific metastases and therapeutic roles of surgery for patients with metastatic bladder cancer: a population-based study

Cited by 45 publications

References 34 publications

Marital Status and Prognostic Nomogram for Bladder Cancer With Distant Metastasis: A SEER-Based Study

Marital Status and Prognostic Nomogram for Bladder Cancer With Distant Metastasis: A SEER-Based Study

Nomograms to Predict Individual Prognosis of Patients with Primary Small Cell Carcinoma of the Bladder

Bone Metastases Pattern in Newly Diagnosed Metastatic Bladder Cancer: A Population-Based Study

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