Cargando…
Development and validation of a preoperative nomogram for predicting survival of patients with locally advanced prostate cancer after radical prostatectomy
BACKGROUND: For selected locally advanced prostate cancer (PCa) patients, radical prostatectomy (RP) is one of the first-line treatments. We aimed to develop a preoperative nomogram to identify what kinds of patients can get the most survival benefits after RP. METHODS: We conducted analyses with da...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001324/ https://www.ncbi.nlm.nih.gov/pubmed/32019501 http://dx.doi.org/10.1186/s12885-020-6565-5 |
_version_ | 1783494219561697280 |
---|---|
author | Zhou, Xianghong Ning, Qingyang Jin, Kun Zhang, Tao Ma, Xuelei |
author_facet | Zhou, Xianghong Ning, Qingyang Jin, Kun Zhang, Tao Ma, Xuelei |
author_sort | Zhou, Xianghong |
collection | PubMed |
description | BACKGROUND: For selected locally advanced prostate cancer (PCa) patients, radical prostatectomy (RP) is one of the first-line treatments. We aimed to develop a preoperative nomogram to identify what kinds of patients can get the most survival benefits after RP. METHODS: We conducted analyses with data from the Surveillance, Epidemiology, and End Results (SEER) database. Covariates used for analyses included age at diagnosis, marital status, race, American Joint Committee on Cancer (AJCC) 7th TNM stage, Prostate specific antigen, Gleason biopsy score (GS), percent of positive cores. We estimated the cumulative incidence function for cause-specific death. The Fine and Gray’s proportional subdistribution hazard approach was used to perform multivariable competing risk analyses and reveal prognostic factors. A nomogram was built by these factors (including GS, percent of positive cores and N stage) and validated by concordance index and calibration curves. Risk stratification was established based on the nomogram. RESULTS: We studied 14,185 patients. N stage, GS, and percent of positive cores were the independent prognostic factors used to construct the nomogram. For validating, in the training cohort, the C-index was 0.779 (95% CI 0.736–0.822), and in the validation cohort, the C-index was 0.773 (95% CI 0.710–0.836). Calibration curves showed that the predicted survival and actual survival were very close. The nomogram performed better over the AJCC staging system (C-index 0.779 versus 0.764 for training cohort, and 0.773 versus 0.744 for validation cohort). The new stratification of risk groups based on the nomogram also showed better discrimination than the AJCC staging system. CONCLUSIONS: The preoperative nomogram can provide favorable prognosis stratification ability to help clinicians identify patients who are suitable for surgery. |
format | Online Article Text |
id | pubmed-7001324 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-70013242020-02-10 Development and validation of a preoperative nomogram for predicting survival of patients with locally advanced prostate cancer after radical prostatectomy Zhou, Xianghong Ning, Qingyang Jin, Kun Zhang, Tao Ma, Xuelei BMC Cancer Research Article BACKGROUND: For selected locally advanced prostate cancer (PCa) patients, radical prostatectomy (RP) is one of the first-line treatments. We aimed to develop a preoperative nomogram to identify what kinds of patients can get the most survival benefits after RP. METHODS: We conducted analyses with data from the Surveillance, Epidemiology, and End Results (SEER) database. Covariates used for analyses included age at diagnosis, marital status, race, American Joint Committee on Cancer (AJCC) 7th TNM stage, Prostate specific antigen, Gleason biopsy score (GS), percent of positive cores. We estimated the cumulative incidence function for cause-specific death. The Fine and Gray’s proportional subdistribution hazard approach was used to perform multivariable competing risk analyses and reveal prognostic factors. A nomogram was built by these factors (including GS, percent of positive cores and N stage) and validated by concordance index and calibration curves. Risk stratification was established based on the nomogram. RESULTS: We studied 14,185 patients. N stage, GS, and percent of positive cores were the independent prognostic factors used to construct the nomogram. For validating, in the training cohort, the C-index was 0.779 (95% CI 0.736–0.822), and in the validation cohort, the C-index was 0.773 (95% CI 0.710–0.836). Calibration curves showed that the predicted survival and actual survival were very close. The nomogram performed better over the AJCC staging system (C-index 0.779 versus 0.764 for training cohort, and 0.773 versus 0.744 for validation cohort). The new stratification of risk groups based on the nomogram also showed better discrimination than the AJCC staging system. CONCLUSIONS: The preoperative nomogram can provide favorable prognosis stratification ability to help clinicians identify patients who are suitable for surgery. BioMed Central 2020-02-04 /pmc/articles/PMC7001324/ /pubmed/32019501 http://dx.doi.org/10.1186/s12885-020-6565-5 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Zhou, Xianghong Ning, Qingyang Jin, Kun Zhang, Tao Ma, Xuelei Development and validation of a preoperative nomogram for predicting survival of patients with locally advanced prostate cancer after radical prostatectomy |
title | Development and validation of a preoperative nomogram for predicting survival of patients with locally advanced prostate cancer after radical prostatectomy |
title_full | Development and validation of a preoperative nomogram for predicting survival of patients with locally advanced prostate cancer after radical prostatectomy |
title_fullStr | Development and validation of a preoperative nomogram for predicting survival of patients with locally advanced prostate cancer after radical prostatectomy |
title_full_unstemmed | Development and validation of a preoperative nomogram for predicting survival of patients with locally advanced prostate cancer after radical prostatectomy |
title_short | Development and validation of a preoperative nomogram for predicting survival of patients with locally advanced prostate cancer after radical prostatectomy |
title_sort | development and validation of a preoperative nomogram for predicting survival of patients with locally advanced prostate cancer after radical prostatectomy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001324/ https://www.ncbi.nlm.nih.gov/pubmed/32019501 http://dx.doi.org/10.1186/s12885-020-6565-5 |
work_keys_str_mv | AT zhouxianghong developmentandvalidationofapreoperativenomogramforpredictingsurvivalofpatientswithlocallyadvancedprostatecancerafterradicalprostatectomy AT ningqingyang developmentandvalidationofapreoperativenomogramforpredictingsurvivalofpatientswithlocallyadvancedprostatecancerafterradicalprostatectomy AT jinkun developmentandvalidationofapreoperativenomogramforpredictingsurvivalofpatientswithlocallyadvancedprostatecancerafterradicalprostatectomy AT zhangtao developmentandvalidationofapreoperativenomogramforpredictingsurvivalofpatientswithlocallyadvancedprostatecancerafterradicalprostatectomy AT maxuelei developmentandvalidationofapreoperativenomogramforpredictingsurvivalofpatientswithlocallyadvancedprostatecancerafterradicalprostatectomy |