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A nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation
BACKGROUND: Balloon dilation is a commonly used minimally invasive endourological treatment of ureteral stricture, but the postoperative recurrence rate is relatively high. And factors contributing to recurrence after treatment are poorly understood. Herein, we sought to develop a novel clinical nom...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8444546/ https://www.ncbi.nlm.nih.gov/pubmed/34530805 http://dx.doi.org/10.1186/s12894-021-00896-3 |
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author | Hu, Jintao Lai, Cong Gao, Mingchao Li, Kaiwen He, Wang Zhu, Dingjun Xie, Wenlian Wu, Haihua Xu, Meijuan Huang, Jian Han, Jinli |
author_facet | Hu, Jintao Lai, Cong Gao, Mingchao Li, Kaiwen He, Wang Zhu, Dingjun Xie, Wenlian Wu, Haihua Xu, Meijuan Huang, Jian Han, Jinli |
author_sort | Hu, Jintao |
collection | PubMed |
description | BACKGROUND: Balloon dilation is a commonly used minimally invasive endourological treatment of ureteral stricture, but the postoperative recurrence rate is relatively high. And factors contributing to recurrence after treatment are poorly understood. Herein, we sought to develop a novel clinical nomogram to predict ureteral stricture-free survival in patients suffering from ureter stricture and performed balloon dilation. METHODS: The nomogram was established based on a retrospective analysis of 321 patients who received endoscopic balloon dilation alone for ureter strictures from January 2016 to January 2020 in Sun Yat-sen Memorial Hospital using the Cox regression model. Perioperative clinical data and disease outcomes were analyzed. The primary endpoint was the onset of ureteral re-stricture after ureter balloon dilation. Discrimination of the nomogram was assessed by the concordance index (C-index) and the calibration curve. The results were internally validated using bootstrap resampling. RESULTS: Overall, 321 patients with a median follow-up of 590 days were enrolled in the study, among which 97 patients (30.2%) developed recurrence of ureteral stricture during follow-up. Five variables remained significant predictors of ureteral re-stricture after multivariable analyses: stricture nature (P < 0.001), urinary nitrite (P = 0.041), CKD (P = 0.005), stent retention time (P < 0.001), and balloon size (P = 0.029). The calibration craves for the probability of 1-, 3-, and 5-years stricture-free survival (SFS) presented satisfied with the consistency of nomogram prediction and actual observation. The C-index of the model was 0.74 (95% CI 0.70–0.79). CONCLUSIONS: Our study developed the first nomogram to effectively predict stricture-free survival in patients suffering from ureter stricture after balloon dilation. It is helpful to identify the optimal patients with ureter stricture for balloon dilation and improve treatment outcomes. However, further external validation of the nomogram is warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12894-021-00896-3. |
format | Online Article Text |
id | pubmed-8444546 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-84445462021-09-17 A nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation Hu, Jintao Lai, Cong Gao, Mingchao Li, Kaiwen He, Wang Zhu, Dingjun Xie, Wenlian Wu, Haihua Xu, Meijuan Huang, Jian Han, Jinli BMC Urol Research Article BACKGROUND: Balloon dilation is a commonly used minimally invasive endourological treatment of ureteral stricture, but the postoperative recurrence rate is relatively high. And factors contributing to recurrence after treatment are poorly understood. Herein, we sought to develop a novel clinical nomogram to predict ureteral stricture-free survival in patients suffering from ureter stricture and performed balloon dilation. METHODS: The nomogram was established based on a retrospective analysis of 321 patients who received endoscopic balloon dilation alone for ureter strictures from January 2016 to January 2020 in Sun Yat-sen Memorial Hospital using the Cox regression model. Perioperative clinical data and disease outcomes were analyzed. The primary endpoint was the onset of ureteral re-stricture after ureter balloon dilation. Discrimination of the nomogram was assessed by the concordance index (C-index) and the calibration curve. The results were internally validated using bootstrap resampling. RESULTS: Overall, 321 patients with a median follow-up of 590 days were enrolled in the study, among which 97 patients (30.2%) developed recurrence of ureteral stricture during follow-up. Five variables remained significant predictors of ureteral re-stricture after multivariable analyses: stricture nature (P < 0.001), urinary nitrite (P = 0.041), CKD (P = 0.005), stent retention time (P < 0.001), and balloon size (P = 0.029). The calibration craves for the probability of 1-, 3-, and 5-years stricture-free survival (SFS) presented satisfied with the consistency of nomogram prediction and actual observation. The C-index of the model was 0.74 (95% CI 0.70–0.79). CONCLUSIONS: Our study developed the first nomogram to effectively predict stricture-free survival in patients suffering from ureter stricture after balloon dilation. It is helpful to identify the optimal patients with ureter stricture for balloon dilation and improve treatment outcomes. However, further external validation of the nomogram is warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12894-021-00896-3. BioMed Central 2021-09-16 /pmc/articles/PMC8444546/ /pubmed/34530805 http://dx.doi.org/10.1186/s12894-021-00896-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Hu, Jintao Lai, Cong Gao, Mingchao Li, Kaiwen He, Wang Zhu, Dingjun Xie, Wenlian Wu, Haihua Xu, Meijuan Huang, Jian Han, Jinli A nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation |
title | A nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation |
title_full | A nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation |
title_fullStr | A nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation |
title_full_unstemmed | A nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation |
title_short | A nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation |
title_sort | nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8444546/ https://www.ncbi.nlm.nih.gov/pubmed/34530805 http://dx.doi.org/10.1186/s12894-021-00896-3 |
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