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Preoperative Nomogram of Petros et al for Predicting Non-Organ Confined Urothelial Carcinoma

Description

Petros et al reported a nomogram for predicting high-risk urothelial carcinoma prior to surgery. This can help to identify a patient who may require more aggressive management. The authors are from the University of Texas MD Anderson Cancer Center, University of Texas Southwestern Medical Center and Penn State Health Milton S. Hershey Medical Center.


Patient selection: upper tract urothelial carcinoma (UTUC)

 

Parameters:

(1) biopsy grade (low or high)

(2) architecture (papillary or sessile)

(3) hemoglobin, from 7 to 17 g/dL

(4) clinical T stage

 

points for hemoglobin =

= 141.1 - (8.3 * (hemoglobin))

 

Parameter

Finding

Points

biopsy grade

low

0

 

high

45

architecture

papillary

0

 

sessile

37

clinical stage

cTx, cTa, cTis

0

 

cT1 or cT2

47

 

cT3

100

 

score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 265

• The higher the score the greater the risk for pT3/pT4 and pN+.

• A probability >= 49% is considered high-risk.

 

Score

Probability

< 39.7

< 10%

39.7 to 206.1

X = (0.026419 * (score)) - 3.2361;

probability = 1/(1+EXP((-1)*X))

> 206.1

> 90%

 

Performance:

• The area under the ROC curve is 82% with a 48% sensitivity and 95% specificity.


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