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Prognostic Index for Predicting Prostate Cancer Survival in a Randomized Screening Trial: Development and Validation

SIMPLE SUMMARY: A prognostic index for predicting survival of localized prostate cancer (PCa) up to 15 and 20 years was developed. The prognostic index performed well for predicting PCa survival among screened and non-screened men. The performance of the prediction model was superior to the European...

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Autores principales: Neupane, Subas, Nevalainen, Jaakko, Raitanen, Jani, Talala, Kirsi, Kujala, Paula, Taari, Kimmo, Tammela, Teuvo L. J., Steyerberg, Ewout W., Auvinen, Anssi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865328/
https://www.ncbi.nlm.nih.gov/pubmed/33498854
http://dx.doi.org/10.3390/cancers13030435
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author Neupane, Subas
Nevalainen, Jaakko
Raitanen, Jani
Talala, Kirsi
Kujala, Paula
Taari, Kimmo
Tammela, Teuvo L. J.
Steyerberg, Ewout W.
Auvinen, Anssi
author_facet Neupane, Subas
Nevalainen, Jaakko
Raitanen, Jani
Talala, Kirsi
Kujala, Paula
Taari, Kimmo
Tammela, Teuvo L. J.
Steyerberg, Ewout W.
Auvinen, Anssi
author_sort Neupane, Subas
collection PubMed
description SIMPLE SUMMARY: A prognostic index for predicting survival of localized prostate cancer (PCa) up to 15 and 20 years was developed. The prognostic index performed well for predicting PCa survival among screened and non-screened men. The performance of the prediction model was superior to the European Association of Urology (EAU) risk groups as well as a modified cancer of prostate risk assessment (CAPRA) risk score. We further constructed a simplified risk score in an unscreened population, using the three most relevant predictors. The simplified risk score was applied to predict PCa survival at 10 years from diagnosis to provide more accurate risk estimation as the basis for decision making. ABSTRACT: We developed and validated a prognostic index to predict survival from prostate cancer (PCa) based on the Finnish randomized screening trial (FinRSPC). Men diagnosed with localized PCa (N = 7042) were included. European Association of Urology risk groups were defined. The follow-up was divided into three periods (0–3, 3–9 and 9–20 years) for development and two corresponding validation periods (3–6 and 9–15 years). A multivariable complementary log–log regression model was used to calculate the full prognostic index. Predicted cause-specific survival at 10 years from diagnosis was calculated for the control arm using a simplified risk score at diagnosis. The full prognostic index discriminates well men with PCa with different survival. The area under the curve (AUC) was 0.83 for both the 3–6 year and 9–15 year validation periods. In the simplified risk score, patients with a low risk score at diagnosis had the most favorable survival, while the outcome was poorest for the patients with high risk scores. The prognostic index was able to distinguish well between men with higher and lower survival, and the simplified risk score can be used as a basis for decision making.
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spelling pubmed-78653282021-02-07 Prognostic Index for Predicting Prostate Cancer Survival in a Randomized Screening Trial: Development and Validation Neupane, Subas Nevalainen, Jaakko Raitanen, Jani Talala, Kirsi Kujala, Paula Taari, Kimmo Tammela, Teuvo L. J. Steyerberg, Ewout W. Auvinen, Anssi Cancers (Basel) Article SIMPLE SUMMARY: A prognostic index for predicting survival of localized prostate cancer (PCa) up to 15 and 20 years was developed. The prognostic index performed well for predicting PCa survival among screened and non-screened men. The performance of the prediction model was superior to the European Association of Urology (EAU) risk groups as well as a modified cancer of prostate risk assessment (CAPRA) risk score. We further constructed a simplified risk score in an unscreened population, using the three most relevant predictors. The simplified risk score was applied to predict PCa survival at 10 years from diagnosis to provide more accurate risk estimation as the basis for decision making. ABSTRACT: We developed and validated a prognostic index to predict survival from prostate cancer (PCa) based on the Finnish randomized screening trial (FinRSPC). Men diagnosed with localized PCa (N = 7042) were included. European Association of Urology risk groups were defined. The follow-up was divided into three periods (0–3, 3–9 and 9–20 years) for development and two corresponding validation periods (3–6 and 9–15 years). A multivariable complementary log–log regression model was used to calculate the full prognostic index. Predicted cause-specific survival at 10 years from diagnosis was calculated for the control arm using a simplified risk score at diagnosis. The full prognostic index discriminates well men with PCa with different survival. The area under the curve (AUC) was 0.83 for both the 3–6 year and 9–15 year validation periods. In the simplified risk score, patients with a low risk score at diagnosis had the most favorable survival, while the outcome was poorest for the patients with high risk scores. The prognostic index was able to distinguish well between men with higher and lower survival, and the simplified risk score can be used as a basis for decision making. MDPI 2021-01-24 /pmc/articles/PMC7865328/ /pubmed/33498854 http://dx.doi.org/10.3390/cancers13030435 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Neupane, Subas
Nevalainen, Jaakko
Raitanen, Jani
Talala, Kirsi
Kujala, Paula
Taari, Kimmo
Tammela, Teuvo L. J.
Steyerberg, Ewout W.
Auvinen, Anssi
Prognostic Index for Predicting Prostate Cancer Survival in a Randomized Screening Trial: Development and Validation
title Prognostic Index for Predicting Prostate Cancer Survival in a Randomized Screening Trial: Development and Validation
title_full Prognostic Index for Predicting Prostate Cancer Survival in a Randomized Screening Trial: Development and Validation
title_fullStr Prognostic Index for Predicting Prostate Cancer Survival in a Randomized Screening Trial: Development and Validation
title_full_unstemmed Prognostic Index for Predicting Prostate Cancer Survival in a Randomized Screening Trial: Development and Validation
title_short Prognostic Index for Predicting Prostate Cancer Survival in a Randomized Screening Trial: Development and Validation
title_sort prognostic index for predicting prostate cancer survival in a randomized screening trial: development and validation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865328/
https://www.ncbi.nlm.nih.gov/pubmed/33498854
http://dx.doi.org/10.3390/cancers13030435
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