Nomogram to predict insignificant prostate cancer at radical prostatectomy in korean men: A multi-center study

Jae Seung Chung, Han Yong Choi, Hae Ryoung Song, Seok Soo Byun, Seong Il Seo, Cheryn Song, Jin Seon Cho, Sang Eun Lee, Hanjong Ahn, Eun Sik Lee, Tae Kon Hwang, Wun Jae Kim, Moon Kee Chung, Tae Young Jung, Ho Song Yu, Young Deuk Choi

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7 Citations (Scopus)

Abstract

Purpose: Due to the availability of serum prostate specific antigen (PSA) testing, the detection rate of insignificant prostate cancer (IPC) is increasing. To ensure better treatment decisions, we developed a nomogram to predict the probability of IPC. Materials and Methods: The study population consisted of 1,471 patients who were treated at multiple institutions by radical prostatectomy without neoadjuvant therapy from 1995 to 2008. We obtained nonrandom samples of n = 1,031 for nomogram development, leaving n = 440 for nomogram validation. IPC was defined as pathologic organ-confined disease and a tumor volume of 0.5 cc or less without Gleason grade 4 or 5. Multivariate logistic regression model (MLRM) coefficients were used to construct a nomogram to predict IPC from five variables, including serum prostate specific antigen, clinical stage, biopsy Gleason score, positive cores ratio and maximum % of tumor in any core. The performance characteristics were internally validated from 200 bootstrap resamples to reduce overfit bias. External validation was also performed in another cohort. Results: Overall, 67 (6.5%) patients had a so-called "insignificant" tumor in nomogram development cohort. PSA, clinical stage, biopsy Gleason score, positive core ratio and maximum % of biopsy tumor represented significant predictors of the presence of IPC. The resulting nomogram had excellent discrimination accuracy, with a bootstrapped concordance index of 0.827. Conclusion: Our current nomogram provides sufficiently accurate information in clinical practice that may be useful to patients and clinicians when various treatment options for screen-detected prostate cancer are considered.

Original languageEnglish
Pages (from-to)74-80
Number of pages7
JournalYonsei medical journal
Volume52
Issue number1
DOIs
Publication statusPublished - 2011 Jan

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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    Chung, J. S., Choi, H. Y., Song, H. R., Byun, S. S., Seo, S. I., Song, C., Cho, J. S., Lee, S. E., Ahn, H., Lee, E. S., Hwang, T. K., Kim, W. J., Chung, M. K., Jung, T. Y., Yu, H. S., & Choi, Y. D. (2011). Nomogram to predict insignificant prostate cancer at radical prostatectomy in korean men: A multi-center study. Yonsei medical journal, 52(1), 74-80. https://doi.org/10.3349/ymj.2011.52.1.74