Translational andrology and urology
An interpretable LASSO-Boruta nomogram for non-muscle-invasive bladder cancer recurrence after intravesical instillation
By Li B, Ji G, Wang W and 1 others.
Abstract
Background
Recurrence remains a major clinical challenge in non-muscle-invasive bladder cancer (NMIBC), highlighting the need for interpretable tools for individualized risk assessment. This study aimed to develop a transparent model that estimates recurrence risk in patients with NMIBC after transurethral resection of bladder tumor (TURBT) and intravesical instillation.
Methods
We reviewed 200 patients with NMIBC who received TURBT and postoperative intravesical instillation at the Department of Urology, The Affiliated Hospital of Xuzhou Medical University, from January to December 2020. Recurrence status was determined from follow-up records. We collected baseline variables, preoperative laboratory results, and clinicopathological data. Patients were divided into training and validation sets (7:3). We screened predictors with multivariate Cox regression, least absolute shrinkage and selection operator (LASSO)-Cox regression, and Boruta analysis before building the nomogram. Model performance was checked with receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis (DCA). Shapley additive explanations (SHAP) analysis was used for interpretation, and an R Shiny application was built.