Grüne B.a· Kowalewski K.-F.a· Weiß C.b· Neuberger M.a· Nientiedt M.a· Wenk M.J.a· Hartung F.O.a· Kriegmair M.C.a· Waldbillig F.a

Author affiliations

aDepartment of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
bDepartment of Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

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Article / Publication Details

First-Page Preview

Received: July 09, 2022
Accepted: December 22, 2022
Published online: February 22, 2023

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 2

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Abstract

Introduction: First external validation of the Bladder Complexity Score (BCS) for predicting complex transurethral resection of bladder tumours (TURBT). Methods: For BCS calculation, TURBTs performed at our institution between January 2018 and December 2019 were reviewed for the presence of preoperative characteristics listed in the Bladder Complexity Checklist (BCC). Receiver operating characteristics (ROC) analysis was used for BCS validation. To establish a modified BCS (mBCS) with maximum area under the curve (AUC), multivariable logistic regression (MLR) analysis was performed with all BCC-characteristics for different definitions of complex TURBT. Results: 723 TURBTs were included in statistical analyses. Cohort’s mean BCS was 11.2 ± 2.4 points (range: 5.5–22 points). In ROC analysis, BCS could not predict complex TURBT (AUC 0.573 [95% CI: 0.517–0.628]). MLR identified tumour size (OR 2.662, p < 0.001), and tumour number > 10 (OR 6.390, p = 0.032) as sole predictors for the modified endpoint of complex TURBT defined as a procedure meeting > 1 criterion: incomplete resection, surgery > 1 h, intraoperative complication, postoperative complications Clavien-Dindo ≥ III. mBCS increased the prediction to an AUC of 0.770 (95% CI: 0.667–0.874). Conclusion: In this first external validation, BCS remained an insufficient predictor of complex TURBT. mBCS requires reduced parameters, is more predictive and easier to apply in clinical practice.

© 2023 S. Karger AG, Basel

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First-Page Preview

Received: July 09, 2022
Accepted: December 22, 2022
Published online: February 22, 2023

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 2

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

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