Developing a prediction model for disease-free survival from upper urinary tract urothelial carcinoma in the Korean population

on behalf of Urothelial Cancer-Advanced Research, Treatment (UCART) study group

Research output: Contribution to journalArticle

Abstract

Background: In this study, we aimed to propose a validated prediction model for disease-free survival (DFS) after radical nephroureterectomy (RNU) in a Korean population with upper urinary tract urothelial carcinoma (UTUC). Methods: We performed a retrospective review of 1561 cases of UTUC who underwent either open RNU (ONU, n = 906) or laparoscopic RNU (LNU, n = 615) from five tertiary Korean institutions between January 2000 and December 2012. Data were used to develop a prediction model using the Cox proportional hazards model. Prognostic factors were selected using the backward variable selection method. The prediction model performance was investigated using Harrell's concordance index (C-index) and Hosmer-Lemeshow type 2 statistics. Internal validation was performed using a bootstrap approach, and the National Cancer Center data set (n = 128) was used for external validation. Results: A best-fitting prediction model with seven significant factors was developed. The C-index and two Hosmer-Lemeshow type statistics of the prediction model were 0.785 (95% CI, 0.755-0.815), 4.810 (P = 0.8506), and 5.285 (P = 0.8088). The optimism-corrected estimate through the internal validation was 0.774 (95% CI, 0.744-0.804) and the optimism-corrected calibration curve was close to the ideal line with mean absolute error = 0.012. In external validation, the discrimination was 0.657 (95% CI, 0.560-0.755) and the two calibration statistics were 0.790 (P = 0.9397) and 3.103 (P = 0.5408), respectively. Conclusion: A validated prediction model based on a large Korean RNU cohort was developed with acceptable performance to estimate DFS in patients with UTUC.

Original languageEnglish
JournalCancer Medicine
DOIs
Publication statusPublished - 2019 Jan 1

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Urinary Tract
Disease-Free Survival
Carcinoma
Calibration
Population
Proportional Hazards Models
Neoplasms
Optimism

Keywords

  • nephroureterectomy
  • prediction model
  • prognosis
  • survival
  • urothelial carcinoma

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Developing a prediction model for disease-free survival from upper urinary tract urothelial carcinoma in the Korean population. / on behalf of Urothelial Cancer-Advanced Research, Treatment (UCART) study group.

In: Cancer Medicine, 01.01.2019.

Research output: Contribution to journalArticle

on behalf of Urothelial Cancer-Advanced Research, Treatment (UCART) study group. / Developing a prediction model for disease-free survival from upper urinary tract urothelial carcinoma in the Korean population. In: Cancer Medicine. 2019.
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abstract = "Background: In this study, we aimed to propose a validated prediction model for disease-free survival (DFS) after radical nephroureterectomy (RNU) in a Korean population with upper urinary tract urothelial carcinoma (UTUC). Methods: We performed a retrospective review of 1561 cases of UTUC who underwent either open RNU (ONU, n = 906) or laparoscopic RNU (LNU, n = 615) from five tertiary Korean institutions between January 2000 and December 2012. Data were used to develop a prediction model using the Cox proportional hazards model. Prognostic factors were selected using the backward variable selection method. The prediction model performance was investigated using Harrell's concordance index (C-index) and Hosmer-Lemeshow type 2 statistics. Internal validation was performed using a bootstrap approach, and the National Cancer Center data set (n = 128) was used for external validation. Results: A best-fitting prediction model with seven significant factors was developed. The C-index and two Hosmer-Lemeshow type statistics of the prediction model were 0.785 (95{\%} CI, 0.755-0.815), 4.810 (P = 0.8506), and 5.285 (P = 0.8088). The optimism-corrected estimate through the internal validation was 0.774 (95{\%} CI, 0.744-0.804) and the optimism-corrected calibration curve was close to the ideal line with mean absolute error = 0.012. In external validation, the discrimination was 0.657 (95{\%} CI, 0.560-0.755) and the two calibration statistics were 0.790 (P = 0.9397) and 3.103 (P = 0.5408), respectively. Conclusion: A validated prediction model based on a large Korean RNU cohort was developed with acceptable performance to estimate DFS in patients with UTUC.",
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author = "{on behalf of Urothelial Cancer-Advanced Research, Treatment (UCART) study group} and Kim, {Sung Han} and Song, {Mi Kyung} and Bumsik Hong and Kang, {Seok Ho} and Jeong, {Byong Chang} and Ku, {Ja Hyun} and Seo, {Ho Kyung}",
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AU - Kim, Sung Han

AU - Song, Mi Kyung

AU - Hong, Bumsik

AU - Kang, Seok Ho

AU - Jeong, Byong Chang

AU - Ku, Ja Hyun

AU - Seo, Ho Kyung

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KW - urothelial carcinoma

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