Evidence map›Paper›PMID 42287324›Full record

ArticleWorld journal of urology2026

Development and multicohort validation of an interpretable postoperative model for intravesical recurrence after radical nephroureterectomy in upper tract urothelial carcinoma.

Cheng Wang, Shuaipeng He, Biao Zhang, Su Zhang, Ning Fan, Hong Chang, Gongjin Wu, Zhongjin Yue, Yu Dai, Hengping Li and 3 more

Abstract readValidation Study
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In one paragraph

Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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13 authors.

Cheng WangDepartment of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.
Shuaipeng HeDepartment of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.
Biao ZhangDepartment of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.
Su ZhangDepartment of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.
Ning FanDepartment of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.
Hong ChangDepartment of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.
Gongjin WuDepartment of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.
Zhongjin YueDepartment of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.
Yu DaiDepartment of Urology, Baoji People's Hospital, Baoji, 721000, Shaanxi, China.
Hengping LiDepartment of Urology, Gansu Provincial Hospital, Lanzhou, Gansu, China.
Jianghou WanDepartment of Urology, Lanzhou University First Hospital, Lanzhou, Gansu, China.
Junhai MaDepartment of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China. junhaiurology@163.com.
Panfeng ShangDepartment of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China. shangpf@lzu.edu.cn.

Funding

Cuiying Science and Technology Innovation Project Project No. CY2024-MS-B10
6 · The paper itself

Abstract

purposeIntravesical recurrence (IVR) after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) is frequent, but postoperative recurrence risk is heterogeneous. We developed and multicohort-validated an interpretable postoperative model for IVR risk stratification after RNU.

methodsWe included 813 patients with pathologically confirmed UTUC treated with RNU across four predefined cohorts: retrospective development (n = 400), retrospective external validation (n = 173), internal prospective validation (n = 166), and external prospective validation (n = 74). Missing data were handled using cohort-specific multiple imputation. A Cox model integrating clinicopathological factors and neutrophil-to-lymphocyte ratio (NLR) was developed and locked in the development cohort, then transported unchanged to validation cohorts. Bootstrap confidence intervals, competing-risk analyses, benchmark comparisons, and sensitivity analyses were performed.

resultsThe locked Cox + NLR model retained tumor location, ureteroscopic manipulation, hydronephrosis, pathological stage, surgical margin status, lymphovascular/perineural invasion, history of bladder cancer, and NLR. Harrell's C-indices were 0.709, 0.746, 0.868, and 0.811 across the four cohorts. At the primary 12-month horizon, AUCs were 0.739, 0.771, 0.953, and 0.791, respectively. Low-risk and high-risk groups remained separated under the competing-risk framework. More complex survival machine-learning models did not show a consistent transportability advantage. The 24-month estimates and surveillance simulation were considered exploratory because prospective follow-up was limited.

conclusionThis interpretable postoperative Cox + NLR model showed favorable multicohort performance for IVR risk stratification after RNU. It may support postoperative risk assessment, but prospective implementation studies are needed before surveillance schedules are changed.

Indexed as

Carcinoma, Transitional CellKidney NeoplasmsNeoplasm Recurrence, LocalNephroureterectomyUreteral NeoplasmsUrinary Bladder NeoplasmsAgedFemaleHumansMaleMiddle AgedPostoperative PeriodProspective StudiesRetrospective StudiesRisk AssessmentCox modelIntravesical recurrencePostoperative predictionRadical nephroureterectomySurveillanceUpper tract urothelial carcinoma

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.