Ospedale Sant'Andrea, Sapienza University of Rome, Roma, Italy.
Ospedale Sant'Andrea, Sapienza University of Rome, Roma, Italy.
Eur J Surg Oncol. 2021 Oct;47(10):2646-2650. doi: 10.1016/j.ejso.2021.04.035. Epub 2021 Apr 30.
Recently, the Cancer of the Bladder Risk Assessment (COBRA) score has been introduced to estimate cancer specific survival (CSS) after radical cystectomy for bladder cancer.
Aim of our study was to validate the COBRA score, assessing the effect of age, tumor stage and lymph-nodes status on CSS after cystectomy in patients with bladder cancer.
DESIGN, SETTING, AND PARTICIPANTS: A consecutive series of 2395 patients with primitive or recurrent bladder cancer treated with radical cystectomy in 4 centers were evaluated.
The role of COBRA score as predictor of CSS was assessed using the Kaplan Meier and Cox proportional hazards analyses. Accuracy of COBRA score was evaluated by Harrell's C test.
Median age was 66 (IQR 58/73) years. Overall, at a median follow-up of 48 (IQR 22/92) months, 642 patients (27%) died of bladder cancer. On Cox proportional hazards analyses, COBRA score was a significant predictor of CSS (HR 1.54, 95%CI 1.47-1.61) (Table 1). The predictive accuracy of the COBRA score was 0.71. A sub analysis including pooled COBRA score (0 vs 1-3 vs 4 vs 5-7) improved the clinical applicability with the same accuracy.
In our experience, the COBRA score is an excellent tool to predict cancer specific survival. The COBRA Score represents a practical and easy tool that may help urologists to classify the CSS of patients treated with radical cystectomy, to predict the oncological outcome and finally to counsel bladder cancer patients.
最近，膀胱癌风险评估（COBRA）评分被引入，以估计膀胱癌根治性膀胱切除术后的癌症特异性生存（CSS）。
我们的研究旨在验证 COBRA 评分，评估年龄、肿瘤分期和淋巴结状态对膀胱癌患者根治性膀胱切除术后 CSS 的影响。
设计、地点和参与者：对 4 个中心接受根治性膀胱切除术治疗的 2395 例原发性或复发性膀胱癌患者进行了连续系列评估。
使用 Kaplan-Meier 和 Cox 比例风险分析评估 COBRA 评分作为 CSS 预测因子的作用。通过 Harrell 的 C 检验评估 COBRA 评分的准确性。
中位年龄为 66 岁（IQR 58/73）。总体而言，在中位随访 48 个月（IQR 22/92）期间，642 例患者（27%）死于膀胱癌。在 Cox 比例风险分析中，COBRA 评分是 CSS 的显著预测因子（HR 1.54，95%CI 1.47-1.61）（表 1）。COBRA 评分的预测准确性为 0.71。包括合并 COBRA 评分（0 与 1-3 与 4-7）的亚分析提高了临床适用性，且准确性相同。
根据我们的经验，COBRA 评分是预测癌症特异性生存的优秀工具。COBRA 评分是一种实用且易于使用的工具，可帮助泌尿科医生对接受根治性膀胱切除术的患者的 CSS 进行分类，预测肿瘤学结果，最终为膀胱癌患者提供咨询。
