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Pre- and post-operative nomograms to predict recurrence-free probability in korean men with clinically localized prostate cancer.

Kang M, Jeong CW, Choi WS, Park YH, Cho SY, Lee S, Lee SB, Ku JH, Hong SK, Byun SS, Jeong H, Kwak C, Kim HH, Lee E, Lee SE, Seoul National University-Uro-Oncology Gro - PLoS ONE (2014)

Bottom Line: In the pre-operative model, Prostate-Specific Antigen (PSA), the proportion of positive biopsy cores, clinical T3a and biopsy Gleason score (GS) were independent predictive factors for BCR, while all relevant predictive factors (PSA, extra-prostatic extension, seminal vesicle invasion, lymph node metastasis, surgical margin, and pathologic GS) were associated with BCR in the post-operative model.In summary, we developed pre- and post-operative nomograms predicting BCR-free probability after RP in a large Korean cohort with clinically localized PCa.These nomograms will be provided as the mobile application-based SNUH Prostate Cancer Calculator.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.

ABSTRACT

Objectives: Although the incidence of prostate cancer (PCa) is rapidly increasing in Korea, there are few suitable prediction models for disease recurrence after radical prostatectomy (RP). We established pre- and post-operative nomograms estimating biochemical recurrence (BCR)-free probability after RP in Korean men with clinically localized PCa.

Patients and methods: Our sampling frame included 3,034 consecutive men with clinically localized PCa who underwent RP at our tertiary centers from June 2004 through July 2011. After inappropriate data exclusion, we evaluated 2,867 patients for the development of nomograms. The Cox proportional hazards regression model was used to develop pre- and post-operative nomograms that predict BCR-free probability. Finally, we resampled from our study cohort 200 times to determine the accuracy of our nomograms on internal validation, which were designated with concordance index (c-index) and further represented by calibration plots.

Results: Over a median of 47 months of follow-up, the estimated BCR-free rate was 87.8% (1 year), 83.8% (2 year), and 72.5% (5 year). In the pre-operative model, Prostate-Specific Antigen (PSA), the proportion of positive biopsy cores, clinical T3a and biopsy Gleason score (GS) were independent predictive factors for BCR, while all relevant predictive factors (PSA, extra-prostatic extension, seminal vesicle invasion, lymph node metastasis, surgical margin, and pathologic GS) were associated with BCR in the post-operative model. The c-index representing predictive accuracy was 0.792 (pre-) and 0.821 (post-operative), showing good fit in the calibration plots.

Conclusions: In summary, we developed pre- and post-operative nomograms predicting BCR-free probability after RP in a large Korean cohort with clinically localized PCa. These nomograms will be provided as the mobile application-based SNUH Prostate Cancer Calculator. Our nomograms can determine patients at high risk of disease recurrence after RP who will benefit from adjuvant therapy.

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Related in: MedlinePlus

Biochemical recurrence (BCR)-free probability during follow-up after radical prostatectomy.
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pone-0100053-g001: Biochemical recurrence (BCR)-free probability during follow-up after radical prostatectomy.

Mentions: The clinical features of the patients are described in Table 1. The mean age was 65.9±6.6 (IQR: 62–71) at the time of RP. The mean preoperative serum PSA level was 11.6±12.2 ng/mL (IQR: 5.1–12.7 ng/mL). Of note, a large proportion of patients in this study had non-aggressive clinical features, including clinical T1c and T2a in 2,726 cases (95.4%), biopsy GS ≤6 in 1,394 cases (48.6%). In contrast, pathologic characteristics were turned to be more aggressive, including EPE in 990 cases (34.5%), SVI in 298 (10.4%), pathologic GS 7 (3+4) in 1,247 cases (43.5%), and GS 7 (4+3) in 547 cases (19.1%). The median follow-up was 47 months. BCR-free survival of the total patients is shown in Figure 1. The estimated BCR-free survival rates were 87.8% at 1 year, 83.8% at 2 year, and 72.5% at 5 year.


Pre- and post-operative nomograms to predict recurrence-free probability in korean men with clinically localized prostate cancer.

Kang M, Jeong CW, Choi WS, Park YH, Cho SY, Lee S, Lee SB, Ku JH, Hong SK, Byun SS, Jeong H, Kwak C, Kim HH, Lee E, Lee SE, Seoul National University-Uro-Oncology Gro - PLoS ONE (2014)

Biochemical recurrence (BCR)-free probability during follow-up after radical prostatectomy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061043&req=5

pone-0100053-g001: Biochemical recurrence (BCR)-free probability during follow-up after radical prostatectomy.
Mentions: The clinical features of the patients are described in Table 1. The mean age was 65.9±6.6 (IQR: 62–71) at the time of RP. The mean preoperative serum PSA level was 11.6±12.2 ng/mL (IQR: 5.1–12.7 ng/mL). Of note, a large proportion of patients in this study had non-aggressive clinical features, including clinical T1c and T2a in 2,726 cases (95.4%), biopsy GS ≤6 in 1,394 cases (48.6%). In contrast, pathologic characteristics were turned to be more aggressive, including EPE in 990 cases (34.5%), SVI in 298 (10.4%), pathologic GS 7 (3+4) in 1,247 cases (43.5%), and GS 7 (4+3) in 547 cases (19.1%). The median follow-up was 47 months. BCR-free survival of the total patients is shown in Figure 1. The estimated BCR-free survival rates were 87.8% at 1 year, 83.8% at 2 year, and 72.5% at 5 year.

Bottom Line: In the pre-operative model, Prostate-Specific Antigen (PSA), the proportion of positive biopsy cores, clinical T3a and biopsy Gleason score (GS) were independent predictive factors for BCR, while all relevant predictive factors (PSA, extra-prostatic extension, seminal vesicle invasion, lymph node metastasis, surgical margin, and pathologic GS) were associated with BCR in the post-operative model.In summary, we developed pre- and post-operative nomograms predicting BCR-free probability after RP in a large Korean cohort with clinically localized PCa.These nomograms will be provided as the mobile application-based SNUH Prostate Cancer Calculator.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.

ABSTRACT

Objectives: Although the incidence of prostate cancer (PCa) is rapidly increasing in Korea, there are few suitable prediction models for disease recurrence after radical prostatectomy (RP). We established pre- and post-operative nomograms estimating biochemical recurrence (BCR)-free probability after RP in Korean men with clinically localized PCa.

Patients and methods: Our sampling frame included 3,034 consecutive men with clinically localized PCa who underwent RP at our tertiary centers from June 2004 through July 2011. After inappropriate data exclusion, we evaluated 2,867 patients for the development of nomograms. The Cox proportional hazards regression model was used to develop pre- and post-operative nomograms that predict BCR-free probability. Finally, we resampled from our study cohort 200 times to determine the accuracy of our nomograms on internal validation, which were designated with concordance index (c-index) and further represented by calibration plots.

Results: Over a median of 47 months of follow-up, the estimated BCR-free rate was 87.8% (1 year), 83.8% (2 year), and 72.5% (5 year). In the pre-operative model, Prostate-Specific Antigen (PSA), the proportion of positive biopsy cores, clinical T3a and biopsy Gleason score (GS) were independent predictive factors for BCR, while all relevant predictive factors (PSA, extra-prostatic extension, seminal vesicle invasion, lymph node metastasis, surgical margin, and pathologic GS) were associated with BCR in the post-operative model. The c-index representing predictive accuracy was 0.792 (pre-) and 0.821 (post-operative), showing good fit in the calibration plots.

Conclusions: In summary, we developed pre- and post-operative nomograms predicting BCR-free probability after RP in a large Korean cohort with clinically localized PCa. These nomograms will be provided as the mobile application-based SNUH Prostate Cancer Calculator. Our nomograms can determine patients at high risk of disease recurrence after RP who will benefit from adjuvant therapy.

Show MeSH
Related in: MedlinePlus