American Urological Association Nonmuscle Invasive Bladder Cancer Risk Model Validation—Should Patient Age be Added to the Risk Model?

No AccessJournal of UrologyAdult Urology1 Oct 2019American Urological Association Nonmuscle Invasive Bladder Cancer Risk Model Validation—Should Patient Age be Added to the Risk Model?This article is commented on by the following:Editorial Comment Kourosh Ravvaz, John A. Weissert, and Tracy M. Downs Kourosh RavvazKourosh Ravvaz *Correspondence: Aurora Research Institute, Aurora Health Care, 960 North 12th St., Milwaukee, Wisconsin 53233 telephone: 414-219-5371; FAX: 414-219-5381; E-mail Address: [email protected] Aurora Research Institute, Aurora Health Care, Milwaukee, Wisconsin More articles by this author , John A. WeissertJohn A. Weissert Aurora Research Institute, Aurora Health Care, Milwaukee, Wisconsin More articles by this author , and Tracy M. DownsTracy M. Downs Department of Urology, School of Medicine and Public Health and Carbone Comprehensive Cancer Center, University of Wisconsin, Madison, Wisconsin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000389AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the AUA (American Urological Association)/SUO (Society of Urologic Oncology) nonmuscle invasive bladder cancer risk model to predict nonmuscle invasive bladder cancer recurrence and progression prior to death. Materials and Methods: We performed a retrospective analysis using electronic medical records and cancer registry data of patients with nonmuscle invasive bladder cancer in a multicenter United States patient population. We evaluated recurrence-free and progression-free survival according to the AUA/SUO nonmuscle invasive bladder cancer risk model. We then assessed discriminative performance with the c-index and compared the cumulative incidence of recurrence, progression and death across 4 age groups. Results: We identified 1,297 patients with nonmuscle invasive bladder cancer. Median followup in the cohort was 3.2 years. The c-index of the AUA/SUO recurrence model was 0.62 and for progression it was higher at 0.77. Patients younger than 60 years had a 40% greater probability of recurrent nonmuscle invasive bladder cancer vs death while patients 84 years old or older had a 12% greater probability of death prior to recurrence at 5 years. This study was limited by its retrospective design. Conclusions: The AUA/SUO nonmuscle invasive bladder cancer risk model provides predictive performance of recurrence and progression similar to that of previous similar risk models, such as the models of the European Organization for Research and Treatment of Cancer, the Club Urológico Español de Tratamiento Oncológico and the National Comprehensive Cancer Network®. This work illustrates the need to consider age in predictive tools for clinicians who treat patients with nonmuscle invasive bladder cancer. References 1. National Cancer Institute: Cancer Stat Facts: Bladder Cancer2019. Available at https://seer.cancer.gov/statfacts/html/urinb.html. Accessed May 14, 2019. Google Scholar 2. : Diagnosis and treatment of non-muscle invasive bladder cancer: AUA/SUO guideline. J Urol 2016; 196: 1021. Link, Google Scholar 3. : Guideline of guidelines: non-muscle-invasive bladder cancer. BJU Int 2017; 119: 371. 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No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byNabavizadeh R and Joshi S (2019) Editorial CommentJournal of Urology, VOL. 203, NO. 3, (511-511), Online publication date: 1-Mar-2020.Related articlesJournal of Urology6 Sep 2019Editorial Comment Volume 202Issue 4October 2019Page: 682-688 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.Keywordssocietiesriskneoplasm recurrencedecision support techniquesbladder neoplasmsmedicallocalAcknowledgmentMary Kissinger and Lisa Robinson, Aurora Health Care Cancer Registry and Aurora Research Institute Research Analytics assisted with data extraction and support. Glenn Allen reviewed the data.MetricsAuthor Information Kourosh Ravvaz Aurora Research Institute, Aurora Health Care, Milwaukee, Wisconsin *Correspondence: Aurora Research Institute, Aurora Health Care, 960 North 12th St., Milwaukee, Wisconsin 53233 telephone: 414-219-5371; FAX: 414-219-5381; E-mail Address: [email protected] More articles by this author John A. Weissert Aurora Research Institute, Aurora Health Care, Milwaukee, Wisconsin More articles by this author Tracy M. Downs Department of Urology, School of Medicine and Public Health and Carbone Comprehensive Cancer Center, University of Wisconsin, Madison, Wisconsin More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. Supported by an Aurora Oncology Award. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Advertisement PDF downloadLoading ...