A predictive model of survival after radical cystectomy for carcinoma of the bladder

Objective To evaluate the effect of patient and tumour characteristics on t he disease-free survival after radical cystectomy for infiltrating bladder cancer, and to use these to help in constructing a meaningful prognostic in dex. Methods The disease-free survival was initially evaluated in 1026 patients (the reference series, 1969-1990). A multivariate analysis showed that the tumour P stage, grade and nodal involvement were the only factors which had an independent and significant association with survival. The computed reg ression coefficients were then used to classify patients into one of four r isk categories and the results then validated by applying the model to a pr ospective test series (1991-1995). Results The 5-year disease-free survival of both groups was similar. When t he results for the risk categories of the reference series were compared wi th those of the test series, there was no significant difference. Conclusion This comprehensive prognostic model for the results of radical c ystectomy was validated and verified in a prospective group of patients. Ad juvant therapies are indicated for patients with a high risk score.