title: Clinical predictors for high-grade bladder cancer before first-time transurethral resection of the bladder tumor: a retrospective cohort study.
abstract: The aim of this study was to identify the clinical predictors related to the risk of high-grade bladder cancer before first-time transurethral resection of the bladder tumor (TUR-Bt) and to externally validate the accuracy of Shapur's nomogram predicting the risk of high-grade bladder cancer in Japanese patients. As a result, episode of gross hematuria (odds ratio: 2.68, P = 0.02), larger tumor size (odds ratio: 1.89, P < 0.01) and positive urinary cytology (odds ratio: 8.34, P < 0.01) were found to be significant predictors for high-grade bladder cancer. Furthermore, the nomogram showed a high predictive accuracy in our Japanese population (area under the curve: 0.79). Clinicians will be able to predict high-grade bladder cancer using the common factors in Shapur's study and ours, such as tumor size and urinary cytology, and gross hematuria as the additional factor first identified here to decide priorities for the treatment of patients diagnosed with bladder cancer.
authors: Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan.
authors: Ken
authors: K
authors: Wakai
authors: Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan takanobu.utsumi@med.toho-u.ac.jp.
authors: Takanobu
authors: T
authors: Utsumi
authors: Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan.
authors: Ryo
authors: R
authors: Oka
authors: Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan.
authors: Takumi
authors: T
authors: Endo
authors: Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan.
authors: Masashi
authors: M
authors: Yano
authors: Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan.
authors: Shuichi
authors: S
authors: Kamijima
authors: Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan.
authors: Naoto
authors: N
authors: Kamiya
authors: Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan.
authors: Nobuyuki
authors: N
authors: Hiruta
authors: Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan.
authors: Hiroyoshi
authors: H
authors: Suzuki
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000368:Aged; D019540:Area Under Curve; D015331:Cohort Studies; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D016017:Odds Ratio; D012372:ROC Curve; D012189:Retrospective Studies; D012306:Risk; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery
keywords: bladder cancer; high-grade; nomogram; transurethral resection of the bladder tumor; validation