Risk stratification for locoregional recurrence after radical cystectomy for XXXX .

@entity1 @entity1803 @entity5 @entity1600 @entity150 @entity3
PURPOSE: To externally validate the Christodouleas risk model incorporating pathological @entity5 stage, @entity1600 ( @entity1600 ) count and soft tissue surgical margin (STSM) and stratifying @entity1 who develop locoregional recurrence (LR) after radical cystectomy (RC) for @entity150 ( @entity150 ). In addition, we aimed to generate a new model including established clinicopathological features that were absent in the Christodouleas risk model. METHODS: Prospectively assessed multicenter data from 565 @entity1 undergoing RC for @entity150 in 2011 qualified for final analysis. For the purpose of external validation, risk group stratification according to Christodouleas was performed. Competing-risk models were calculated to compare the cumulative incidences of LR after RC. RESULTS: After a median follow-up of 25  months (interquartile range 19-29), the LR-rate was 11.5  %. The Christodouleas model showed a predictive accuracy of 83.2  % in our cohort. In multivariable competing-risk analysis, @entity5 stage >= @entity1803 (HR 4.32, p  <  0.001), positive STSM (HR 2.93, p  =  0.005), @entity3 (HR 3.41, p  <  0.001), the number of removed LNs <10 (HR 2.62, p  <  0.001) and the administration of adjuvant chemotherapy (HR 0.40, p  =  0.008) independently predicted the LR-rate. The resulting risk groups revealed significant differences in LR-rates after 24  months with 4.8  % for low-risk @entity1 , 14.7  % for intermediate-risk @entity1 and 38.9  % for high-risk @entity1 (p  <  0.001 for all), with a predictive accuracy of 85.6  %, respectively. CONCLUSIONS: The Christodouleas risk model has been successfully externally validated in the present prospective series. However, this analysis finds that overall model performance may be improved by incorporating @entity3 . After external validation of the newly proposed risk model, it may be used to identify @entity1 who benefit from an adjuvant therapy and suit for inclusion in clinical trials.
