Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510289, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510289, China.
Curr Oncol. 2022 Sep 23;29(10):6834-6846. doi: 10.3390/curroncol29100539.
(1) Purpose: The purpose of this study was to evaluate the prognostic capacity of the pathological N status (pN), lymph node ratio (LNR), and the log odds of positive lymph nodes (LODDS), and to build a prognostic nomogram to predict overall survival (OS) for bladder cancer patients treated by radical cystectomy. (2) Methods: The clinical and pathological characteristics of 10,938 patients with bladder cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2017. The predictive capacity was assessed by univariate and multivariate Cox regression analyses, the area under the receiver operating characteristic curve (AUC), and C-index. Calibration curves, decision curve analysis (DCA), and risk-grouping were utilized to evaluate the predictive accuracy and discriminative ability of the nomogram. (3) Results: LODDS was an independent risk factor for bladder cancer (all < 0.001) and demonstrated the highest values of C-index and AUC. The values of AUCs in the training cohort were 0.747, 0.743, and 0.735 for predicting 1-, 3-, and 5-year OS, respectively. Calibration curves and DCA curves suggested the excellent clinical application value of our nomogram. (4) Conclusions: LODDS is a better predictive indicator for bladder cancer patients compared to pN and LNR. The LODDS-incorporated nomogram has excellent accuracy and promising clinical application value for non-metastatic bladder cancer after radical cystectomy.
(1)目的：本研究旨在评估病理 N 分期（pN）、淋巴结比率（LNR）和阳性淋巴结对数优势比（LODDS）的预后能力，并构建一个列线图预测接受根治性膀胱切除术治疗的膀胱癌患者的总生存（OS）。
(2)方法：从 2004 年至 2017 年，从监测、流行病学和最终结果（SEER）数据库中确定了 10938 例膀胱癌患者的临床和病理特征。通过单因素和多因素 Cox 回归分析、受试者工作特征曲线（ROC）下面积（AUC）和 C 指数评估预测能力。校准曲线、决策曲线分析（DCA）和风险分组用于评估列线图的预测准确性和判别能力。
(3)结果：LODDS 是膀胱癌的独立危险因素（均<0.001），且具有最高的 C 指数和 AUC 值。在训练队列中，预测 1、3 和 5 年 OS 的 AUC 值分别为 0.747、0.743 和 0.735。校准曲线和 DCA 曲线表明我们的列线图具有出色的临床应用价值。
(4)结论：与 pN 和 LNR 相比，LODDS 是预测膀胱癌患者的更好指标。LODDS 纳入的列线图对于接受根治性膀胱切除术的非转移性膀胱癌具有出色的准确性和有前途的临床应用价值。
