Development of a nomogram incorporating serum C-reactive protein level to predict overall survival of patients with advanced urothelial carcinoma and its evaluation by decision curve analysis

Br J Cancer. 2012 Sep 25;107(7):1031-6. doi: 10.1038/bjc.2012.254. Epub 2012 Aug 23.

Abstract

Background: The purpose of this study is to investigate the prognostic impact of C-reactive protein (CRP) on patients with advanced urothelial carcinoma and to develop a novel nomogram predicting survival.

Methods: A total of 223 consecutive patients were treated at Tokyo Medical and Dental Hospital. A nomogram incorporating V was developed based on the result of a Cox proportional hazards model. Its efficacy and clinical usefulness was evaluated by concordance index (c-index) and decision curve analysis.

Results: Of the 223 patients, 184 (83%) died of cancer. Median follow-up periods of patients who died and those who remained alive were 5 and 11 months, respectively. We developed a novel nomogram incorporating Eastern Cooperative Oncology Group Performance Status, presence of visceral metastasis, haemoglobin and age. The c-index of the nomogram predicting survival probability 6 and 12 months after diagnosis was 0.788 and 0.765, respectively. Decision curve analyses revealed that the novel nomogram incorporating CRP had a superior net benefit than that without CRP for most of the examined probabilities.

Conclusion: We demonstrated the prognostic impact of CRP that improved the predictive accuracy of a nomogram for survival probability in patients with advanced urothelial carcinoma.

MeSH terms

  • Aged
  • C-Reactive Protein / metabolism*
  • Carcinoma, Transitional Cell / blood*
  • Decision Support Techniques*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Nomograms*
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Urinary Bladder Neoplasms / blood
  • Urologic Neoplasms / blood*

Substances

  • C-Reactive Protein