Table 4. Assessment of urinary “shed” ALCAM as a predictor in a multivariable Cox regression analysis of 3-year overall survival in the VUMC bladder cancer cohort.

	Variable	Hazard Ratio	95.0% CI	Significance	Bootstrap Significance
Model 1	Age (Years)	1.06a	1.03–1.10	< 0.001	0.001
	Tumor Stage	1.28a	1.07–1.52	0.006	0.008
	Lymph-node Positive	2.62a	1.27–5.38	0.009	0.016
	Urine Hemoglobin (μg/ml)	1.00a	0.99–1.00	0.116	0.189
	C-Index	75.2%	68.8–81.5		73.5Ψ
Model 2	Age (Years)	1.74b	1.05–2.87	< 0.001	0.001
	Tumor Stage	1.98c	1.36–2.89	< 0.001	0.002
	Lymph-node Positive	2.03	0.96–4.30	0.065	0.034
	Urine Hemoglobin (μg/ml)	1.07d	0.93–1.23	0.329	0.729
	Urine ALCAM (ng/ml)	1.46e	1.03–2.06	0.002	0.005
	Urine ALCAM X Age*			0.031	0.023
	C-Index	78.5%	72.4–84.6		76.0Ψ
Model 3	Age (Years)	1.06	1.02–1.11	0.004	0.020
	Tumor Stage	1.37	1.06–1.76	0.015	0.022
	Lymph-node Positive	1.60	0.64–4.02	0.314	0.343
	Urine Hemoglobin (μg/ml)	1.00	0.99–1.00	0.435	0.529
	Urine Creatinine (mg/dl)	1.00	0.99–1.00	0.875	0.889
	Urine ALCAM (ng/ml)	1.10	1.02–1.19	0.011	0.018
	BCG Treatment	0.62	0.29–1.36	0.233	0.310
	CIS Present	1.79	0.86–3.72	0.119	0.129
	# Lymph-nodes Removed	1.00	0.95–1.04	0.918	0.931
	Lymphovascular Invasion	1.45	0.53–3.98	0.467	0.549
	Adjuvant Chemotherapy	0.77	0.30–1.96	0.581	0.634

Assessment of urinary shed ALCAM as a predictor of 3-year overall survival by multivariable Cox regression analysis in the VUMC cohort. Hazard Ratio is the adjusted hazards ratio. CI, confidence interval. BCG, Bacillus Calmette-Guérin. CIS, carcinoma in situ. Bootstrap significance is two-tailed with 1000 iterations and a Mersenne twister of 2,000,000. Hazard ratio is the adjusted hazard ratio for

^aevery 1 unit increase,

^burine ALCAM at 2.06 ng/ml, but 13 years older,

^c2 tumor stage increase,

^d1.03 μg/ml higher urine hemoglobin, and

^e69 year old with a 5.03 ng/ml increase in urine ALCAM.

^*Interaction term. C-Index, Harrell's Concordance Index [41].

^Ψinternal validation of the C-Index, confidence interval calculations not available.