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

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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 postoperative 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, extraprostatic 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.

Original languageEnglish
Article numbere100053
JournalPLoS ONE
Volume9
Issue number6
DOIs
StatePublished - 17 Jun 2014

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Nomograms
prostatic neoplasms
Prostatic Neoplasms
Prostatectomy
Recurrence
prostate-specific antigen
relapse
biopsy
Biopsy
calibration
Prostate-Specific Antigen
Neoplasm Grading
seminal vesicles
Calibration
cohort studies
metastasis
Mobile Applications
adjuvants
Korean Peninsula
lymph nodes

Cite this

@article{05d8059e10de455aaafeb01d111beab5,
title = "Pre- and post-operative nomograms to predict recurrence-free probability in Korean men with clinically localized prostate cancer",
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 postoperative 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, extraprostatic 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.",
author = "Minyong Kang and Jeong, {Chang Wook} and Choi, {Woo Suk} and Park, {Yong Hyun} and Cho, {Sung Yong} and Lee, {Sang Chul} and Lee, {Seung Bae} and Ku, {Ja Hyeon} and Hong, {Sung Kyu} and Seok-Soo Byun and Hyeon Jeong and Cheol Kwak and Kim, {Hyeon Hoe} and Eunsik Lee and Lee, {Sang Eun}",
year = "2014",
month = "6",
day = "17",
doi = "10.1371/journal.pone.0100053",
language = "English",
volume = "9",
journal = "PloS one",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "6",

}

TY - JOUR

T1 - Pre- and post-operative nomograms to predict recurrence-free probability in Korean men with clinically localized prostate cancer

AU - Kang, Minyong

AU - Jeong, Chang Wook

AU - Choi, Woo Suk

AU - Park, Yong Hyun

AU - Cho, Sung Yong

AU - Lee, Sang Chul

AU - Lee, Seung Bae

AU - Ku, Ja Hyeon

AU - Hong, Sung Kyu

AU - Byun, Seok-Soo

AU - Jeong, Hyeon

AU - Kwak, Cheol

AU - Kim, Hyeon Hoe

AU - Lee, Eunsik

AU - Lee, Sang Eun

PY - 2014/6/17

Y1 - 2014/6/17

N2 - 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 postoperative 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, extraprostatic 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.

AB - 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 postoperative 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, extraprostatic 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.

UR - http://www.scopus.com/inward/record.url?scp=84903289150&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0100053

DO - 10.1371/journal.pone.0100053

M3 - Article

C2 - 24936784

AN - SCOPUS:84903289150

VL - 9

JO - PloS one

JF - PloS one

SN - 1932-6203

IS - 6

M1 - e100053

ER -