A nomogram for predicting overall survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy: a retrospective cohort study

Background and aimsRadical cystectomy (RC) remains the standard treatment for localized and regionally muscle-invasive bladder cancer (MIBC). However, only half of patients with MIBC survive more than 5 years after RC. We explored the factors associated with overall survival (OS) and constructed a p...

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Main Authors: Haiming Huang, Han Hao, Jialin Du, Lu Pang, Qian Ma, Haixia Li, Lei Jin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1597107/full
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author Haiming Huang
Haiming Huang
Han Hao
Jialin Du
Lu Pang
Qian Ma
Haixia Li
Lei Jin
author_facet Haiming Huang
Haiming Huang
Han Hao
Jialin Du
Lu Pang
Qian Ma
Haixia Li
Lei Jin
author_sort Haiming Huang
collection DOAJ
description Background and aimsRadical cystectomy (RC) remains the standard treatment for localized and regionally muscle-invasive bladder cancer (MIBC). However, only half of patients with MIBC survive more than 5 years after RC. We explored the factors associated with overall survival (OS) and constructed a prognostic nomogram for predicting 1-, 3-, and 5-year OS after RC.MethodsThe data were sourced from the Surveillance, Epidemiology, and End Results (SEER) database and Peking University First Hospital (PKUFH). Univariate and multivariate Cox regression analyses were performed using the minimum value of the Akaike information criterion to select independent prognostic factors that significantly contributed to patient survival. A prognostic nomogram was designed to predict 1-, 3-, and 5-year OS.ResultsAmong the 16,949 patients with MIBC undergoing surgery, 31.15% survived for more than 5 years. The nomogram we created demonstrated satisfactory discriminative ability to predict the survival of MIBC patients with RC, with area under curve (AUC) of 0.939, 0.880 and 0.852 for 1-, 3- and 5-year OS in the testing set. Moreover, the nomogram still exhibited good performance in an externally independent dataset (1-year: AUC=0.970; 3-year: AUC=0.847; 5-year: AUC=0.790). Furthermore, decision curve analyses showed a modest net benefit for the use of the MIBC nomogram in the current cohort compared to the use of American Joint Committee on Cancer staging alone.ConclusionsA prognostic nomogram was developed and validated to help clinicians evaluate the prognosis of postoperative MIBC patients. The future integration of additional data will likely improve model performance and accuracy for personalized prognostics.
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spelling doaj-art-57deb3f148dc4a13a0645be571c0ea492025-08-20T02:09:59ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.15971071597107A nomogram for predicting overall survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy: a retrospective cohort studyHaiming Huang0Haiming Huang1Han Hao2Jialin Du3Lu Pang4Qian Ma5Haixia Li6Lei Jin7Department of Clinical Laboratory, Peking University First Hospital, Beijing, ChinaInstitute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, ChinaDepartment of Urology, Peking University First Hospital and Institute of Urology, Beijing, ChinaDepartment of Clinical Laboratory, Peking University First Hospital, Beijing, ChinaDepartment of Clinical Laboratory, Peking University First Hospital, Beijing, ChinaDepartment of Clinical Laboratory, Peking University First Hospital, Beijing, ChinaDepartment of Clinical Laboratory, Peking University First Hospital, Beijing, ChinaInstitute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, ChinaBackground and aimsRadical cystectomy (RC) remains the standard treatment for localized and regionally muscle-invasive bladder cancer (MIBC). However, only half of patients with MIBC survive more than 5 years after RC. We explored the factors associated with overall survival (OS) and constructed a prognostic nomogram for predicting 1-, 3-, and 5-year OS after RC.MethodsThe data were sourced from the Surveillance, Epidemiology, and End Results (SEER) database and Peking University First Hospital (PKUFH). Univariate and multivariate Cox regression analyses were performed using the minimum value of the Akaike information criterion to select independent prognostic factors that significantly contributed to patient survival. A prognostic nomogram was designed to predict 1-, 3-, and 5-year OS.ResultsAmong the 16,949 patients with MIBC undergoing surgery, 31.15% survived for more than 5 years. The nomogram we created demonstrated satisfactory discriminative ability to predict the survival of MIBC patients with RC, with area under curve (AUC) of 0.939, 0.880 and 0.852 for 1-, 3- and 5-year OS in the testing set. Moreover, the nomogram still exhibited good performance in an externally independent dataset (1-year: AUC=0.970; 3-year: AUC=0.847; 5-year: AUC=0.790). Furthermore, decision curve analyses showed a modest net benefit for the use of the MIBC nomogram in the current cohort compared to the use of American Joint Committee on Cancer staging alone.ConclusionsA prognostic nomogram was developed and validated to help clinicians evaluate the prognosis of postoperative MIBC patients. The future integration of additional data will likely improve model performance and accuracy for personalized prognostics.https://www.frontiersin.org/articles/10.3389/fonc.2025.1597107/fullmuscle-invasive bladder cancerradical cystectomynomogramrisk factorsoverall survival
spellingShingle Haiming Huang
Haiming Huang
Han Hao
Jialin Du
Lu Pang
Qian Ma
Haixia Li
Lei Jin
A nomogram for predicting overall survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy: a retrospective cohort study
Frontiers in Oncology
muscle-invasive bladder cancer
radical cystectomy
nomogram
risk factors
overall survival
title A nomogram for predicting overall survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy: a retrospective cohort study
title_full A nomogram for predicting overall survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy: a retrospective cohort study
title_fullStr A nomogram for predicting overall survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy: a retrospective cohort study
title_full_unstemmed A nomogram for predicting overall survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy: a retrospective cohort study
title_short A nomogram for predicting overall survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy: a retrospective cohort study
title_sort nomogram for predicting overall survival in patients with muscle invasive bladder cancer undergoing radical cystectomy a retrospective cohort study
topic muscle-invasive bladder cancer
radical cystectomy
nomogram
risk factors
overall survival
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1597107/full
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