SynthesisUrologic oncology2026
A systematic review and meta-analysis of clinicopathologic factors associated with adverse oncologic outcomes in bladder cancer patients undergoing radical cystectomy: Evidence from multivariable survival prediction models.
Synthesis in Urologic oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Beyond staging: toward a layered risk architecture after radical cystectomy for bladder cancer.Translational andrology and urology · 2026Article
- Preoperative predictors of adverse pathological outcomes following radical cystectomy for muscle-invasive bladder cancer in a tertiary referral center.Journal of medicine and life · 2026Article
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13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This systematic review aimed to identify robust clinicopathologic predictors of overall (OS), cancer-specific (CSS), and recurrence-free survival (RFS) following radical cystectomy (RC) from published prediction models. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) recommendations were followed, and the study was registered in PROSPERO (CRD42024509410). MEDLINE (Ovid) and Embase (Elsevier) were searched from inception to January 2024 for studies developing or validating multivariable prediction models in patients undergoing RC for non-metastatic bladder cancer. Data were extracted following the CHARMS checklist, and risk of bias was assessed using the PROBAST (Prediction model Risk Of Bias Assessment) tool. Pooled hazard ratios (HRs) were estimated with DerSimonian-Laird random-effects models. Seventy-seven studies involving survival models met the inclusion criteria: 36 for OS, 44 for CSS, and 26 for RFS. For OS, adverse predictors included advanced age (HR 1.03, 95% confidence interval [CI] 1.02-1.04), gender (female) (HR 1.08, 95% CI 1.01-1.14), higher pathologic T stage, lymph node involvement (HR 1.91, 95% CI 1.70-2.14), lymphovascular invasion (LVI) (HR 1.49, 95% CI 1.40-1.58), positive surgical margins (HR 1.74, 95% CI 1.46-2.06), and concomitant carcinoma in situ (HR 1.09, 95% CI 1.03-1.16). Neoadjuvant (HR 0.66, 95% CI 0.47-0.93) and adjuvant chemotherapy (HR 0.74, 95% CI 0.71-0.76) and compliance with pentafecta criteria (HR 0.49, 95% CI 0.30-0.79) were associated with improved OS. CSS displayed similar prognostic patterns, with additional associations for lymph node density, hydronephrosis, sarcopenia, and elevated neutrophil-lymphocyte ratio. This meta-analysis identified consistent clinicopathologic predictors of adverse oncological outcomes after RC for bladder cancer. Systematic assessment of these variables allows more accurate postoperative prognostic stratification and supports clinical decision-making regarding adjuvant treatment selection, surveillance intensification, and patient counseling.
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