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 language | English |
|---|---|
| Journal | Cancer Medicine |
| DOIs | |
| Publication status | Published - 2019 Jan 1 |
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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 journal › Article
}
TY - JOUR
T1 - Developing a prediction model for disease-free survival from upper urinary tract urothelial carcinoma in the Korean population
AU - on behalf of Urothelial Cancer-Advanced Research, Treatment (UCART) study group
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
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - nephroureterectomy
KW - prediction model
KW - prognosis
KW - survival
KW - urothelial carcinoma
UR - http://www.scopus.com/inward/record.url?scp=85068707055&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068707055&partnerID=8YFLogxK
U2 - 10.1002/cam4.2382
DO - 10.1002/cam4.2382
M3 - Article
AN - SCOPUS:85068707055
JO - Cancer Medicine
JF - Cancer Medicine
SN - 2045-7634
ER -