ABSTRACT

In this review we highlight important risk factors and available prognostic models for predicting outcomes after radical cystectomy for bladder cancer. The American Joint Committee on Cancer TNM staging system is commonly used to predict the risk of recurrence after radical cystectomy. Although this staging system yielded useful estimates of recurrence risk and survival outcomes, significant variation within each group has been observed due to the heterogeneity of the tumor biology and patient characteristics. Multiple prognostic models can be applied to patients treated with radical cystectomy. For patients with bladder cancer, these tools can guide the clinician with respect to treatment selection. They can assess the risk of recurrence and/or mortality and can guide the type and frequency of follow-up considerations for patients treated with radical cystectomy. While these nomograms currently represent the most accurate tools for predicting outcomes in patients with bladder cancer, they have inherent limitations. Despite their advantages, nomograms cannot replace clinical judgment. Addition of novel bio-markers, modern imaging tools and other prognostic factors may improve predictive capability and improve the clinical utility of these valuable models. Validation in large patient cohorts and prospective data acquisition need to emphasis.