Shariat et al developed 2 nomograms for evaluating a patient following a radical cystectomy for bladder cancer. This can help to identify a patient who may benefit from more aggressive management. The authors are from University of Texas Southwestern, University of Montreal, Baylor College of Medicine, University of Rochester, and University of Southern California at Los Angeles.
Patient selection: radical cystectomy with bilateral lymphadenectomy for a non-T4, N0 M0 tumor
Outcomes:
(1) 5 year relapse free survival (RFS)
(2) 5 year cancer specific survival (CSS)
Parameters:
(1) pathologic T score
(2) lymphovascular invasion (LVI)
(3) number of altered molecular biomarkers (p53, pRB, p21, p27, cyclin E1)
|
Parameter |
Finding |
Points RFS |
Points CSS |
|
pathologic T score |
Ta, Tis, T1 |
4 |
0 |
|
|
T2 |
0 |
29 |
|
|
T3 |
41 |
65 |
|
lymphovascular spread |
absent |
0 |
0 |
|
|
present |
27 |
34 |
|
altered markers |
0 to 2 |
0 |
0 |
|
|
3 |
58 |
56 |
|
|
4 or 5 |
100 |
100 |
total score for RFS =
= SUM(points for the 3 parameters)
total score for CSS =
= SUM(points for the 3 parameters)
Interpretation:
• minimum score: 0
• maximum score for relapse free survival: 180
• maximum score for cancer specific survival: 220
|
5 Year RFS |
RFS Score |
|
< 1 |
> 96% |
|
1 to 123 |
(-0.003442 * ((points)^2)) - (0.01393 * (points)) + 94.47 |
|
123 to 162 |
(0.005033 * ((points)^2)) - (2.214 * (points)) + 236.7 |
|
> 162 |
< 10% |
|
5 Year CSS |
CSS Score |
|
< 3 |
> 98% |
|
3 to 85 |
(-0.001525 * ((points)^2)) - (0.00951 * (points)) + 97.95 |
|
85 to 150 |
(-0.003647 * ((points)^2)) + (0.3009 * (points)) + 86.8 |
|
150 to 199 |
(0.004359 * ((points)^2)) - (2.344 * (points)) + 303.7 |
|
>= 200 |
< 10% |
Specialty: Hematology Oncology, Surgery, general, Urology
ICD-10: ,
