Thursday, October 15, 2009
THURSDAY, Oct. 15 (HealthDay News) -- In the management of bladder cancer patients who have undergone cystectomy, use of a multivariate prediction model ("bladder nomogram") for referral to adjuvant chemotherapy may lead to better outcomes than the use of pathologic stage, according to a study published online Oct. 12 in Cancer.
Andrew J. Vickers, Ph.D., of the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues analyzed data on 4,462 patients who underwent cystectomy without chemotherapy between 1969 and 2004.
In all scenarios of drug effectiveness and tolerability, the researchers found that a nomogram cutoff outperformed pathologic stage for chemotherapy. In a typical comparison, they found that use of the nomogram would reduce referrals to adjuvant chemotherapy by 14 percent with only a 0.4 percent increase in disease recurrences. They said that this improved outcome resulted solely from changing a decision rule without any additional tests, procedures or treatments.
"Given the importance of this finding -- that we can improve outcome merely by changing the basis on which we make decisions -- we recommend research on other multivariate prediction models to determine their clinical effects," the authors conclude.
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