Sophie Chen '23
Major: Religious Studies & Natural Science
Bio: Sophie Chen was born and raised in New York, NY, and is currently pursuing degrees in Natural Science and Religious Studies. After graduating from Fordham, she intends to pursue a medical degree and continue engaging in scientific research in her areas of interest.
Title of Research: Development of a predictive model for recurrence-free survival in pTa low-grade bladder cancer
Mentor: Dr. Jorge Daza, Society of Urologic Oncology fellow at Roswell Park Cancer Institute
Abstract: Non-muscle invasive bladder cancer (NMIBC) accounts for ~75% of newly diagnosed bladder cancer cases. We developed a predictive model associated with recurrence-free survival (RFS) at 6, 12, 18, and 24 months in Ta low-grade (LG) bladder cancer cases that consider patients’ risk aversion. We hypothesize that this model will help select the best follow-up schedule of newly diagnosed TaLG bladder cancer patients leading to a net reduction in interventions per 100 patients. Analysis was performed on 202 patients with newly diagnosed Ta low-grade NMIBC, who did not receive adjuvant intravesical therapy, from a population-based prospectively maintained database of patients treated in Stockholm County, Sweden. We performed a classification tree regression analysis to identify risk groups associated with recurrence. Association between risk groups and RFS was evaluated by Kaplan Meier analysis. A Cox proportional hazard model selected significant risk factors associated with RFS from the risk groups. The model was internally validated and calibrated using 1000 bootstrapped samples. A nomogram was generated to estimate RFS at 6, 12, 18, and 24 months. The performance of our model was compared to EUA/AUA stratification using a decision curve analysis (DCA). The classification tree found that tumor number, size, and age were the most relevant variables associated with recurrence and significantly associated with RFS in the Cox proportional hazard model. The patients with the highest likelihood of recurrence were those with multifocal (93%) or single ≥ 4cm tumors (92%). Our model outperformed the AUA/EUA stratification via DCA in terms of net benefit and net reduction in interventions per 100 patients. These findings need further validation with an external data set.