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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

Calibration plots for pre- and post-operative nomograms predicting biochemical recurrence (BCR)-free probability on internal validation for 2 years after radical prostatectomy.Panel (A) and (B) represent calibration plots, respectively, for pre- and post-operative nomograms. Bootstrapping method was used for the internal validation of these nomograms. Grey line indicates the predictive performance of a perfect nomogram, and black line represents the predictive accuracy of our nomograms.
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pone-0100053-g003: Calibration plots for pre- and post-operative nomograms predicting biochemical recurrence (BCR)-free probability on internal validation for 2 years after radical prostatectomy.Panel (A) and (B) represent calibration plots, respectively, for pre- and post-operative nomograms. Bootstrapping method was used for the internal validation of these nomograms. Grey line indicates the predictive performance of a perfect nomogram, and black line represents the predictive accuracy of our nomograms.

Mentions: Based on these results, we established graphical pre- and post-operative nomograms predicting the probability of BCR after RP (Figure 2-A and 2-B). On internal validation, the predictive accuracy of pre- and post-operative nomograms was 0.792 and 0.821 of c-index, respectively. The calibration plot for pre- (Figure 3-A) and post-operative nomograms (Figure 3-B) showed good correspondence between predicted and actual probability of BCR at two years, indicating these nomograms were well calibrated.


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)

Calibration plots for pre- and post-operative nomograms predicting biochemical recurrence (BCR)-free probability on internal validation for 2 years after radical prostatectomy.Panel (A) and (B) represent calibration plots, respectively, for pre- and post-operative nomograms. Bootstrapping method was used for the internal validation of these nomograms. Grey line indicates the predictive performance of a perfect nomogram, and black line represents the predictive accuracy of our nomograms.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0100053-g003: Calibration plots for pre- and post-operative nomograms predicting biochemical recurrence (BCR)-free probability on internal validation for 2 years after radical prostatectomy.Panel (A) and (B) represent calibration plots, respectively, for pre- and post-operative nomograms. Bootstrapping method was used for the internal validation of these nomograms. Grey line indicates the predictive performance of a perfect nomogram, and black line represents the predictive accuracy of our nomograms.
Mentions: Based on these results, we established graphical pre- and post-operative nomograms predicting the probability of BCR after RP (Figure 2-A and 2-B). On internal validation, the predictive accuracy of pre- and post-operative nomograms was 0.792 and 0.821 of c-index, respectively. The calibration plot for pre- (Figure 3-A) and post-operative nomograms (Figure 3-B) showed good correspondence between predicted and actual probability of BCR at two years, indicating these nomograms were well calibrated.

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