Skip to main content

ORIGINAL RESEARCH article

Front. Oncol.
Sec. Genitourinary Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1442168

A New Nomogram for Predicting Extraurothelial Recurrence in Patients with Upper Urinary Tract Urothelial Carcinoma Following Radical Nephroureterectomy

Provisionally accepted
Hao Wu Hao Wu Dan Jia Dan Jia Xianyu Dai Xianyu Dai Hongliang Cao Hongliang Cao Fulin Wang Fulin Wang Tong Yang Tong Yang Tao Xu Tao Xu Lei Wang Lei Wang Baoshan Gao Baoshan Gao *
  • First Affiliated Hospital of Jilin University, Changchun, China

The final, formatted version of the article will be published soon.

    Purpose: We sought to develop and validate a nomogram for predicting extra-urinary recurrence (EUR) following radical nephroureterectomy (RNU) in patients with upper urinary tract urothelial carcinoma (UTUC). Methods: Data from 556 UTUC patients post-RNU at the First Hospital of Jilin University were retrospectively analyzed. These patients were categorized into a training group (n=389) and a validation group (n=167). Variables significantly associated with prognosis were identified using univariate Cox regression and most minor absolute shrinkage and selection operator (LASSO) analysis. These independent predictors were incorporated into the nomogram to estimate extra-urinary recurrencefree survival (EURFS). Validation of the nomogram involved ROC curves, calibration plots, and decision curve analysis (DCA). Patients were stratified into two risk categories based on their nomogram scores to compare EURFS using the Kaplan-Meier method.Results: Eight predictors were identified: T-stage, N-stage, tumor grade, local and nerve invasion, preoperative hemoglobin level, neutrophil-to-lymphocyte ratio (NLR), and creatinine, all proving to be independent predictors of EUR. A nomogram was created based on these eight factors, and using the ROC, calibration curves, and DCA, good prediction results were shown in both the training and validation groups. The training and validation groups also showed reliable predictive performance. In particular, there was a significant difference in survival between the high-risk and lowrisk groups (P<0.0001). We have also built a network calculator that calculates patient survival time. The URL is https://haowu24.shinyapps.io/dynnomapp.A nomogram for predicting distant metastases in UTUC patients was successfully developed, and its accuracy, reliability, and clinical value were demonstrated. This new tool helps to improve the clinical management of UTUC cases.

    Keywords: Upper urinary tract urothelial carcinoma, Radical nephroureterectomy, extra-urinary recurrence, Prediction model, Online network calculator

    Received: 01 Jun 2024; Accepted: 11 Oct 2024.

    Copyright: © 2024 Wu, Jia, Dai, Cao, Wang, Yang, Xu, Wang and Gao. 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: Baoshan Gao, First Affiliated Hospital of Jilin University, Changchun, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.