Precystectomy Nomogram for Prediction of Advanced Bladder Cancer Stage{A figure is presented}

Pierre I. Karakiewicz, Shahrokh F. Shariat, Ganesh S. Palapattu, Paul Perrotte, Yair Lotan, Craig G. Rogers, Gilad E. Amiel, Amnon Vazina, Amit Gupta, Patrick J. Bastian, Arthur I. Sagalowsky, Mark Schoenberg, Seth P. Lerner

Research output: Contribution to journalArticlepeer-review

142 Scopus citations


Objective: To evaluate precystectomy prediction of pT and pN stages at cystectomy. Methods: Multivariate logistic regression analyses modelled variables of 726 evaluable patients treated with radical cystectomy and bilateral pelvic lymphadenectomy. The first set of models predicted pT3-4 stage at cystectomy, and the second set predicted pN1-3 stages at cystectomy. Transurethral resection (TUR) predictors consisted of 2002 T stage, 1973 WHO tumour grade, presence of carcinoma in situ, age, gender, and delivery of neo-adjuvant chemotherapy. The area under the ROC curve quantified nomogram accuracy. Two hundred bootstrap resamples were used to reduce overfit bias. Results: At TUR, 11% of patients were staged as pT3-4 versus 42% at cystectomy. Lymph node metastases were found in 24% of patients at cystectomy (pN1-3). The multivariate pT3-4 nomogram was 75.7% accurate versus 71.4% for TUR T stage. The multivariate pN1-3 nomogram was 63.1% accurate versus 61.0% for TUR T stage. Conclusion: Multivariate nomograms are not perfect, but they do predict more accurately than TUR T stage alone.

Original languageEnglish (US)
Pages (from-to)1254-1262
Number of pages9
JournalEuropean Urology
Issue number6
StatePublished - Dec 2006
Externally publishedYes


  • Bladder cancer
  • Cystectomy
  • Grade
  • Nomogram
  • Prediction
  • Stage

ASJC Scopus subject areas

  • Urology


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