ORIGINAL RESEARCH article
Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1571604
Development and Validation of Nomograms for Predicting Prognosis in Patients with Resectable Bladder Urothelial Carcinoma Undergoing Radical Cystectomy: A Multi-Center Retrospective Study
Provisionally accepted
- 1Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China, Qingdao, China
- 2School of Rehabilitation, Capital Medical University, Beijing, China; Department of Urology, China Rehabilitation Research Center, Beijing, China, Beijing, China
- 3Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital & Institute, Beijing, China, Beijing, China
- 4Department of Urology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China, Qingdao, China
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AbstractPurpose: This study aims to construct and validate nomograms to predict overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) in patients with resectable bladder urothelial carcinoma (BUC) after radical cystectomy (RC). Methods: We retrospectively collected demographic, pathological, imaging, and laboratory data from patients with BUC who underwent RC. The training cohort included patients from the Affiliated Hospital of Qingdao University from January 2018 to December 2021, while the testing cohort included patients from the same hospital between January 2016 to December 2017 and from Qilu Hospital of Shandong University. Univariate and multivariate COX regression analyses were conducted to identify independent predictors for OS, CSS, and DFS. The performance of the nomograms was evaluated using the Harrell’s consistency index (C-index), the area under the receiver operating characteristic (ROC) curve (AUC), the corrected AUC following 1000-Bootstrap resampling with calibration curves, and the decision curve analysis in both cohorts validation. Results: A total of 393 patients were included in the training cohort and 156 in the testing cohort. Multivariate analyses revealed that age, tumor size, lymph node metastasis (LNM), lymphovascular invasion (LVI), urea nitrogen, creatinine, and the albumin/fibrinogen ratio (AFR) were independent predictors for OS. For CSS, the independent predictors were tumor size, LNM, LVI, urea nitrogen, and AFR. LNM and LVI were independent predictors for DFS. The nomograms for OS and CSS demonstrated high predictive accuracy with robust C-indexes and ROC curves, as well as reliable calibration curves with corrected AUCs and clinical utility in both cohorts. The DFS nomogram also showed high predictive accuracy with stable corrected AUCs in both cohorts. Conclusion: We constructed OS, CSS, and DFS nomograms to predict prognosis in BUC patients treated with RC. These nomograms exhibited high accuracy, reliability, and clinical utility in predicting outcomes in both cohorts.
Keywords: Bladder cancer, Bladder urothelial carcinoma, Radical cystectomy, prognosis, nomogram
Received: 05 Feb 2025; Accepted: 12 Jun 2025.
Copyright: © 2025 Ji, Wen, Yao, Jiang, Yang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Guiming Zhang, Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China, Qingdao, China
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