Risk of Recurrence Following Surgery

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This nomogram calculates the risk of bladder cancer recurrence for individual patients after radical cystectomy (surgical removal of the entire bladder) and pelvic lymph node dissection (removal of the surrounding lymph nodes). It is appropriate only for bladder cancer patients who received surgery without chemotherapy.

In consultation with a physician, patients can use this tool to calculate the likelihood that they will be free of bladder cancer five years after surgical treatment for their cancer. Risk of recurrence (the return of a cancer after a period during which it could not be detected) is a key factor in determining the need for additional therapies after bladder cancer surgery.

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Are you male or female?

How old were you at the time of the surgery? years (20 to 95)

In days, how long was the time interval between pathologic diagnosis of your bladder cancer (from the biopsy) and your surgery (radical cystectomy) to remove the cancer? days (0 to 1000)

What is radical cystectomy?: Radical cystectomy is removal of the entire bladder and nearby organs that may contain cancer cells.

What was the tumor stage identified at the time of surgery (radical cystectomy) using the AJCC Version 7 TNM Staging System (2009/2010)?

More on TNM Staging

The global standard in bladder cancer staging is the TNM Staging System, which uses TNM classifications to describe the extent of cancer in a patient's body. T describes the size of the tumor and whether it has invaded nearby tissue; N describes whether regional lymph nodes are involved and, if so, how extensively; and M describes whether distant metastasis (spread of cancer from one body part to another) is present. The system is maintained by the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC) and is updated periodically, most recently in 2009/10 (Version 7).

T0 - No evidence of primary tumor
Tis - Carcinoma in situ: “flat tumor” on inner lining
Ta - Noninvasive papillary carcinoma on inner lining of the bladder
T1 - Tumor invades connective tissue next to the inner lining
T2 - Tumor invades the layer of muscle tissue within the bladder
T3 - Tumor invades the tissues surrounding the bladder
T4 - Tumor invades one or more of the following: the abdomen or pelvis; one or more lymph node; other parts of the body (e.g., liver, lung, bone)

What was the histology of your bladder cancer?

What is histology?: Histology refers to the exact type of cancer based on examination of the tumor tissue under the microscope. Bladder cancer is classified as either Transitional cell carcinoma; Squamous cell carcinoma; or Adenocarcinoma.

What was your node result?

What is node result?: Node result refers to whether the cancer has spread to the pelvic lymph nodes. If no cancer is found in the lymph nodes, the node result is "Negative." If cancer is found in the lymph nodes, the result is "Positive."

What grade were the cancer cells?

What is grade?: Tumor grade refers to the extent of abnormality of the cells when viewed under the microscope. "Low Grade" cells look normal and grow slowly. "High Grade" cells look abnormal and grow quickly.

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