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Constructing prognostic model incorporating the 2004 WHO/ISUP classification for patients with non-muscle-invasive urothelial tumours of the urinary bladder
  1. Chin-Chen Pan1,
  2. Yen-Hwa Chang2,
  3. Kuang-Kuo Chen2,
  4. Hui-Jung Yu1,
  5. Chih-Hao Sun1,
  6. Donald M T Ho1
  1. 1Department of Pathology, Taipei Veterans General Hospital & National Yang-Ming University, Taipei, Taiwan
  2. 2Division of Urology, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
  1. Correspondence to Dr Chin-Chen Pan, Department of Pathology, Taipei Veterans General Hospital, No 201, Shi-Pai Rd, Sec 2, Taipei 11217, Taiwan; ccpan{at}


Aim To construct a prognostic model for recurrence-free survival (RFS), progression-free survival (PFS) and cancer-specific survival (CSS) for patients who have undergone transurethral resection of non-muscle-invasive (pTa/pT1) urinary bladder urothelial tumours.

Methods 1366 patients who had undergone transurethral resection of primary non-muscle-invasive urothelial tumours (pTa, 891 patients; pT1, 475 patients) confined to the bladder were retrospectively studied. Tumours were classified according to the 2004 WHO/International Society of Urologic Pathology grading system. Kaplan–Meier and stepwise Cox regression models were applied, and 200 bootstrap resamples were used to generate survival estimates and 95% CIs. A nomogram was developed that incorporated significant variables predicting survival.

Results RFS, PFS and CSS probabilities for non-muscle-invasive bladder urothelial tumours were calculated. Incorporating salient prognostic factors (tumour grade, pT stage, patient age, status of intravesical instillation), the model satisfactorily predicted PFS (concordance index=0.79) and CSS (concordance index=0.87).

Conclusions Robust nomograms were created to predict PFS and CSS. These data provide an overall perspective of disease outcomes which may aid in developing individualised follow-up programmes.

  • Non-muscle-invasive urothelial tumour
  • urinary bladder
  • prognostic model
  • nomogram
  • recurrence
  • progression
  • survival
  • urinary tract tumours

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  • Funding The work was supported by a grant from Taipei Veterans General Hospital (No V97C1-009).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the institutional review board of Taipei Veterans General Hospital (No 96-06-10A).

  • Provenance and peer review Not commissioned; externally peer reviewed.