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Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients

BACKGROUND: Incontinence and sexual dysfunction are long-lasting side effects after surgical treatment (radical prostatectomy, RP) of prostate cancer (PC). For an informed treatment decision, physicians and patients should discuss expected impairments. Therefore, this paper firstly aims to develop a...

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Autores principales: Sibert, Nora Tabea, Kurth, Tobias, Breidenbach, Clara, Wesselmann, Simone, Feick, Günther, Carl, Ernst-Günter, Dieng, Sebastian, Albarghouth, Mohamad Hatem, Aziz, Atiqullah, Baltes, Stefan, Bartolf, Elisabeth, Bedke, Jens, Blana, Andreas, Brock, Marko, Conrad, Stefan, Darr, Christopher, Distler, Florian, Drosos, Konstantinos, Duwe, Gregor, Gaber, Amr, Giessing, Markus, Harke, Nina Natascha, Heidenreich, Axel, Hijazi, Sameh, Hinkel, Andreas, Kaftan, Björn Theodor, Kheiderov, Shatlyk, Knoll, Thomas, Lümmen, Gerd, Peters, Inga, Polat, Bülent, Schrodi, Valentin, Stolzenburg, Jens-Uwe, Varga, Zoltan, von Süßkind-Schwendi, Julius, Zugor, Vahudin, Kowalski, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691723/
https://www.ncbi.nlm.nih.gov/pubmed/38039308
http://dx.doi.org/10.1371/journal.pone.0295179
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author Sibert, Nora Tabea
Kurth, Tobias
Breidenbach, Clara
Wesselmann, Simone
Feick, Günther
Carl, Ernst-Günter
Dieng, Sebastian
Albarghouth, Mohamad Hatem
Aziz, Atiqullah
Baltes, Stefan
Bartolf, Elisabeth
Bedke, Jens
Blana, Andreas
Brock, Marko
Conrad, Stefan
Darr, Christopher
Distler, Florian
Drosos, Konstantinos
Duwe, Gregor
Gaber, Amr
Giessing, Markus
Harke, Nina Natascha
Heidenreich, Axel
Hijazi, Sameh
Hinkel, Andreas
Kaftan, Björn Theodor
Kheiderov, Shatlyk
Knoll, Thomas
Lümmen, Gerd
Peters, Inga
Polat, Bülent
Schrodi, Valentin
Stolzenburg, Jens-Uwe
Varga, Zoltan
von Süßkind-Schwendi, Julius
Zugor, Vahudin
Kowalski, Christoph
author_facet Sibert, Nora Tabea
Kurth, Tobias
Breidenbach, Clara
Wesselmann, Simone
Feick, Günther
Carl, Ernst-Günter
Dieng, Sebastian
Albarghouth, Mohamad Hatem
Aziz, Atiqullah
Baltes, Stefan
Bartolf, Elisabeth
Bedke, Jens
Blana, Andreas
Brock, Marko
Conrad, Stefan
Darr, Christopher
Distler, Florian
Drosos, Konstantinos
Duwe, Gregor
Gaber, Amr
Giessing, Markus
Harke, Nina Natascha
Heidenreich, Axel
Hijazi, Sameh
Hinkel, Andreas
Kaftan, Björn Theodor
Kheiderov, Shatlyk
Knoll, Thomas
Lümmen, Gerd
Peters, Inga
Polat, Bülent
Schrodi, Valentin
Stolzenburg, Jens-Uwe
Varga, Zoltan
von Süßkind-Schwendi, Julius
Zugor, Vahudin
Kowalski, Christoph
author_sort Sibert, Nora Tabea
collection PubMed
description BACKGROUND: Incontinence and sexual dysfunction are long-lasting side effects after surgical treatment (radical prostatectomy, RP) of prostate cancer (PC). For an informed treatment decision, physicians and patients should discuss expected impairments. Therefore, this paper firstly aims to develop and validate prognostic models that predict incontinence and sexual function of PC patients one year after RP and secondly to provide an online decision making tool. METHODS: Observational cohorts of PC patients treated between July 2016 and March 2021 in Germany were used. Models to predict functional outcomes one year after RP measured by the EPIC-26 questionnaire were developed using lasso regression, 80–20 splitting of the data set and 10-fold cross validation. To assess performance, R(2), RMSE, analysis of residuals and calibration-in-the-large were applied. Final models were externally temporally validated. Additionally, percentages of functional impairment (pad use for incontinence and firmness of erection for sexual score) per score decile were calculated to be used together with the prediction models. RESULTS: For model development and internal as well as external validation, samples of 11 355 and 8 809 patients were analysed. Results from the internal validation (incontinence: R(2) = 0.12, RMSE = 25.40, sexual function: R(2) = 0.23, RMSE = 21.44) were comparable with those of the external validation. Residual analysis and calibration-in-the-large showed good results. The prediction tool is freely accessible: https://nora-tabea.shinyapps.io/EPIC-26-Prediction/. CONCLUSION: The final models showed appropriate predictive properties and can be used together with the calculated risks for specific functional impairments. Main strengths are the large study sample (> 20 000) and the inclusion of an external validation. The models incorporate meaningful and clinically available predictors ensuring an easy implementation. All predictions are displayed together with risks of frequent impairments such as pad use or erectile dysfunction such that the developed online tool provides a detailed and informative overview for clinicians as well as patients.
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spelling pubmed-106917232023-12-02 Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients Sibert, Nora Tabea Kurth, Tobias Breidenbach, Clara Wesselmann, Simone Feick, Günther Carl, Ernst-Günter Dieng, Sebastian Albarghouth, Mohamad Hatem Aziz, Atiqullah Baltes, Stefan Bartolf, Elisabeth Bedke, Jens Blana, Andreas Brock, Marko Conrad, Stefan Darr, Christopher Distler, Florian Drosos, Konstantinos Duwe, Gregor Gaber, Amr Giessing, Markus Harke, Nina Natascha Heidenreich, Axel Hijazi, Sameh Hinkel, Andreas Kaftan, Björn Theodor Kheiderov, Shatlyk Knoll, Thomas Lümmen, Gerd Peters, Inga Polat, Bülent Schrodi, Valentin Stolzenburg, Jens-Uwe Varga, Zoltan von Süßkind-Schwendi, Julius Zugor, Vahudin Kowalski, Christoph PLoS One Research Article BACKGROUND: Incontinence and sexual dysfunction are long-lasting side effects after surgical treatment (radical prostatectomy, RP) of prostate cancer (PC). For an informed treatment decision, physicians and patients should discuss expected impairments. Therefore, this paper firstly aims to develop and validate prognostic models that predict incontinence and sexual function of PC patients one year after RP and secondly to provide an online decision making tool. METHODS: Observational cohorts of PC patients treated between July 2016 and March 2021 in Germany were used. Models to predict functional outcomes one year after RP measured by the EPIC-26 questionnaire were developed using lasso regression, 80–20 splitting of the data set and 10-fold cross validation. To assess performance, R(2), RMSE, analysis of residuals and calibration-in-the-large were applied. Final models were externally temporally validated. Additionally, percentages of functional impairment (pad use for incontinence and firmness of erection for sexual score) per score decile were calculated to be used together with the prediction models. RESULTS: For model development and internal as well as external validation, samples of 11 355 and 8 809 patients were analysed. Results from the internal validation (incontinence: R(2) = 0.12, RMSE = 25.40, sexual function: R(2) = 0.23, RMSE = 21.44) were comparable with those of the external validation. Residual analysis and calibration-in-the-large showed good results. The prediction tool is freely accessible: https://nora-tabea.shinyapps.io/EPIC-26-Prediction/. CONCLUSION: The final models showed appropriate predictive properties and can be used together with the calculated risks for specific functional impairments. Main strengths are the large study sample (> 20 000) and the inclusion of an external validation. The models incorporate meaningful and clinically available predictors ensuring an easy implementation. All predictions are displayed together with risks of frequent impairments such as pad use or erectile dysfunction such that the developed online tool provides a detailed and informative overview for clinicians as well as patients. Public Library of Science 2023-12-01 /pmc/articles/PMC10691723/ /pubmed/38039308 http://dx.doi.org/10.1371/journal.pone.0295179 Text en © 2023 Sibert et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Sibert, Nora Tabea
Kurth, Tobias
Breidenbach, Clara
Wesselmann, Simone
Feick, Günther
Carl, Ernst-Günter
Dieng, Sebastian
Albarghouth, Mohamad Hatem
Aziz, Atiqullah
Baltes, Stefan
Bartolf, Elisabeth
Bedke, Jens
Blana, Andreas
Brock, Marko
Conrad, Stefan
Darr, Christopher
Distler, Florian
Drosos, Konstantinos
Duwe, Gregor
Gaber, Amr
Giessing, Markus
Harke, Nina Natascha
Heidenreich, Axel
Hijazi, Sameh
Hinkel, Andreas
Kaftan, Björn Theodor
Kheiderov, Shatlyk
Knoll, Thomas
Lümmen, Gerd
Peters, Inga
Polat, Bülent
Schrodi, Valentin
Stolzenburg, Jens-Uwe
Varga, Zoltan
von Süßkind-Schwendi, Julius
Zugor, Vahudin
Kowalski, Christoph
Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients
title Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients
title_full Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients
title_fullStr Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients
title_full_unstemmed Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients
title_short Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients
title_sort prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691723/
https://www.ncbi.nlm.nih.gov/pubmed/38039308
http://dx.doi.org/10.1371/journal.pone.0295179
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