medical decision support medical decision support
Sign In

International Bladder Cancer Postoperative Nomogram of Bochner et al for Predicting Recurrence After Radical Cystectomy

Purpose: To evaluate a patient for risk of recurrence following radical cystectomy for bladder cancer using the nomogram of the IBCNC.

Description

The International Bladder Cancer Nomogram Consortium developed a nomogram for predicting the risk of recurrence following radical cystectomy for cancer of the urinary bladder. The authors are from Memorial Sloan-Kettering Cancer Center and multiple medical centers from North America and Europe.


Parameters:

(1) age at radical cystectomy

(2) gender

(3) stage at radical cystectomy using the 1997 TNM criteria

(4) tumor histology in radical cystectomy specimen

(5) lymph node status

(6) number of days from initial cancer diagnosis to radical cystectomy

(7) histologic grade

 

Parameter

Finding

Points

gender of the patient

female

0

 

male

2

TNM stage

pT0

0

 

pTis

22.6

 

pTa

35.3

 

pT1

41.5

 

pT2

50

 

pT3

76.3

 

pT4

100

histology

adenocarcinoma

0

 

squamous cell carcinoma

14.25

 

transitional cell carcinoma

29.6

lymph node status

negative

0

 

positive

12

 

unknown

48

tumor grade

low grade

0

 

high grade

21

 

unknown

28.5

 

where:

• Points for unknown lymph node status and tumor grade are greater than for known values.

 

Age in Years

Points

<= 20

0

20 - 100

(0.005172 * ((age)^2)) - (0.1883 * (age)) + 2.229

> 100

35

 

 

Days from Dx to Surgery

Points

0 to 1,000

(0.05891 * (number of days)) - 1.961

> 1,000

58

 

total score =

= SUM(points for all 7 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: around 260

• The higher the score the more likely that a recurrence will occur.

• The endpoint used was probability of being progression free at 5 years (60 months).

 

Points

Probability Progression Free at 60 Months

< 32.3

> 0.97

32.3 - 132

(-0.000028 * ((points)^2)) + (0.001876 * (points)) + 0.9376

132 - 181.6

(-0.000040 * ((points)^2)) + (0.004620 * (points)) + 0.7955

181.6 - 237

(0.000075 * ((points)^2)) - (0.0368 * (points)) + 4.499

> 237

< 0.01

 


To read more or access our algorithms and calculators, please log in or register.

Specialty

Objective

ICD-10