Prognostic model for predicting survival of patients with metastatic urothelial cancer treated with cisplatin-based chemotherapy

J Natl Cancer Inst. 2013 Apr 3;105(7):499-503. doi: 10.1093/jnci/djt015. Epub 2013 Feb 14.

Abstract

A prognostic model that predicts overall survival (OS) for metastatic urothelial cancer (MetUC) patients treated with cisplatin-based chemotherapy was developed, validated, and compared with a commonly used Memorial Sloan-Kettering Cancer Center (MSKCC) risk-score model. Data from 7 protocols that enrolled 308 patients with MetUC were pooled. An external multi-institutional dataset was used to validate the model. The primary measurement of predictive discrimination was Harrell's c-index, computed with 95% confidence interval (CI). The final model included four pretreatment variables to predict OS: visceral metastases, albumin, performance status, and hemoglobin. The Harrell's c-index was 0.67 for the four-variable model and 0.64 for the MSKCC risk-score model, with a prediction improvement for OS (the U statistic and its standard deviation were used to calculate the two-sided P = .002). In the validation cohort, the c-indices for the four-variable and the MSKCC risk-score models were 0.63 (95% CI = 0.56 to 0.69) and 0.58 (95% CI = 0.52 to 0.65), respectively, with superiority of the four-variable model compared with the MSKCC risk-score model for OS (the U statistic and its standard deviation were used to calculate the two-sided P = .02).

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / mortality*
  • Cisplatin / administration & dosage
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Doxorubicin / administration & dosage
  • Female
  • Humans
  • Ifosfamide / administration & dosage
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / mortality*
  • Male
  • Middle Aged
  • Nomograms
  • Paclitaxel / administration & dosage
  • Predictive Value of Tests
  • Prognosis
  • Survival Analysis
  • Treatment Outcome
  • Urothelium / pathology

Substances

  • Deoxycytidine
  • Doxorubicin
  • gemcitabine
  • Paclitaxel
  • Cisplatin
  • Ifosfamide