Mortality prediction models after radical cystectomy for bladder tumour: A systematic review and critical appraisal.
Por:
Sarrió-Sanz P, Martinez-Cayuelas L, Lumbreras B, Sánchez-Caballero L, Palazón-Bru A, Gil-Guillén VF and Gómez-Pérez L
Publicada:
1 oct 2022
Ahead of Print:
13 jun 2022
Resumen:
INTRODUCTION: To identify risk-predictive models for bladder-specific cancer mortality in patients undergoing radical cystectomy and assess their clinical utility and risk of bias. METHODS: Systematic review (CRD42021224626:PROSPERO) in Medline and EMBASE (from their creation until 31/10/2021) was screened to include articles focused on the development and internal validation of a predictive model of specific cancer mortality in patients undergoing radical cystectomy. CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS) and Prediction model Risk Of Bias ASsessment Tool (PROBAST) were applied. RESULTS: Nineteen observational studies were included. The main predictors were sociodemographic variables, such as age (18 studies, 94.7%) and sex (17, 89.5% studies), tumour characteristics (TNM stage (18 studies, 94.7%), histological subtype/grade (15 studies, 78.9%), lymphovascular invasion (10 studies, 52.6%) and treatment with chemotherapy (13 studies, 68.4%). C-index values were presented in 14 studies. The overall risk of bias assessed using PROBAST led to 100% of studies being classified as high risk (the analysis domain was rated to be at high risk of bias in all the studies), and 52.6% showed low applicability. Only 5 studies (26.3%) included an external validation and 2 (10.5%) included a prospective study design. CONCLUSIONS: Using clinical predictors to assess the risk of bladder-specific cancer mortality is a feasibility alternative. However, the studies showed a high risk of bias and their applicability is uncertain. Studies should improve the conducting and reporting, and subsequent external validation studies should be developed.
Filiaciones:
Sarrió-Sanz P:
Urology Services, University Hospital of San Juan de Alicante, Alicante, Spain
Martinez-Cayuelas L:
Urology Services, University Hospital of San Juan de Alicante, Alicante, Spain
:
Department of Public Health, History of Science and Gynecology, Miguel Hernández University, and CIBER en Epidemiología y Salud Pública, Alicante, Spain
Sánchez-Caballero L:
Urology Services, University Hospital of San Juan de Alicante, Alicante, Spain
:
Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain
:
Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain
:
Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain
Urology Services, University General Hospital of Elx, Alicante, Spain
Open Access
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