caa a22 4500 605490279 CHVBK 20210128100504.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10147-014-0693-3 doi (NATIONALLICENCE)springer-10.1007/s10147-014-0693-3 External validation of existing nomograms predicting lymph node metastases in cystectomized patients [Elektronische Daten] [Miroslav Stojadinovic, Rade Prelevic] Objectives: Karakiewicz et al. and Green et al. created pre-cystectomy nomograms to predict lymph node involvement. The aim of the study was to externally validate these two nomograms in intermediate-volume institutions in Europe. Patients and methods: Data from a Serbian single-centre cystectomy series comprising 183 patients with bladder cancer were used for the validation of two US nomograms, which were originally based on data from 726 and 201 patients, respectively. A multivariate regression model assessed the value of the clinical parameters integrated in the two nomograms. The expected predictive accuracy, calibration and clinical utility according to the nomograms were calculated. Results: Comparison of our dataset with the previously published data shows differences in nearly all underlying risk variables. Overall, 109 (59.6%) patients had lymph node metastases. The analysis demonstrated that hydronephrosis and status of lymph nodes on computed tomography have independent prognostic value. The performance of the nomograms deteriorated from the development set, and the predictive accuracies for the two models showed moderate discriminatory ability (61.2-69.1%). In the decision curve analysis, only the Green et al. model predicting lymph node positivity provided net benefit. Conclusions: The Green et al. nomogram seems applicable to patients from Europe, despite varying risk factors in the validation dataset. Acceptance of such a tool into daily clinical management may lead to more appropriate decision-making. Nevertheless, further improvement and implementation of novel statistical models with enhanced predictive accuracy is needed. Japan Society of Clinical Oncology, 2014 Bladder cancer nationallicence Radical cystectomy nationallicence Lymph node metastasis nationallicence Validation study nationallicence AUC : Area under the receiver operating characteristic curve nationallicence BC : Bladder cancer nationallicence CI : Confidential interval nationallicence CIS : Carcinoma in situ nationallicence CT : Computed tomography nationallicence LN : Lymph node nationallicence LN+ : Positive lymph node nationallicence LR : Logistic regression nationallicence LVI : Lymphovascular invasion nationallicence MRI : Magnetic resonance imaging nationallicence NC : Neoadjuvant chemotherapy nationallicence NOC : Non organ-confined nationallicence NPV : Negative predictive value nationallicence OR : Odds ratio nationallicence PLND : Pelvic lymph node dissection nationallicence PPV : Positive predictive value nationallicence RC : Radical cystectomy nationallicence ROC : Receiver operating characteristic curve nationallicence TUR : Transurethral resection nationallicence Stojadinovic Miroslav Deparment of Urology, Clinic of Urology and Nephrology, Clinical Centre Kragujevac, Zmaj Jovina 30, 34 000, Kragujevac, Serbia aut Prelevic Rade Military Medical Academy, Clinic of Urology, Belgrade, Serbia aut International Journal of Clinical Oncology Springer Japan 20/1(2015-02-01), 164-170 1341-9625 20:1<164 2015 20 10147 https://doi.org/10.1007/s10147-014-0693-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10147-014-0693-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Stojadinovic Miroslav Deparment of Urology, Clinic of Urology and Nephrology, Clinical Centre Kragujevac, Zmaj Jovina 30, 34 000, Kragujevac, Serbia aut NATIONALLICENCE 700 1- Prelevic Rade Military Medical Academy, Clinic of Urology, Belgrade, Serbia aut NATIONALLICENCE 773 0- International Journal of Clinical Oncology Springer Japan 20/1(2015-02-01), 164-170 1341-9625 20:1<164 2015 20 10147