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

Research output: Contribution to journalArticle

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 1

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Nomograms
Prostatectomy
Prostatic Neoplasms
Prostate-Specific Antigen
Neoplasm Grading
Biopsy
Logistic Models
Neoplasms
Neoadjuvant Therapy
Tumor Burden
Serum
Therapeutics
Population

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Chung, Jae Seung ; Choi, Han Yong ; Song, Hae Ryoung ; Byun, Seok Soo ; Seo, Seong Il ; Song, Cheryn ; Cho, Jin Seon ; Lee, Sang Eun ; Ahn, Hanjong ; Lee, Eun Sik ; Hwang, Tae Kon ; Kim, Wun Jae ; Chung, Moon Kee ; Jung, Tae Young ; Yu, Ho Song ; Choi, Young Deuk. / Nomogram to predict insignificant prostate cancer at radical prostatectomy in korean men : A multi-center study. In: Yonsei medical journal. 2011 ; Vol. 52, No. 1. pp. 74-80.
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title = "Nomogram to predict insignificant prostate cancer at radical prostatectomy in korean men: A multi-center study",
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.",
author = "Chung, {Jae Seung} and Choi, {Han Yong} and Song, {Hae Ryoung} and Byun, {Seok Soo} and Seo, {Seong Il} and Cheryn Song and Cho, {Jin Seon} and Lee, {Sang Eun} and Hanjong Ahn and Lee, {Eun Sik} and Hwang, {Tae Kon} and Kim, {Wun Jae} and Chung, {Moon Kee} and Jung, {Tae Young} and Yu, {Ho Song} and Choi, {Young Deuk}",
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Chung, JS, Choi, HY, Song, HR, Byun, SS, Seo, SI, Song, C, Cho, JS, Lee, SE, Ahn, H, Lee, ES, Hwang, TK, Kim, WJ, Chung, MK, Jung, TY, Yu, HS & Choi, YD 2011, 'Nomogram to predict insignificant prostate cancer at radical prostatectomy in korean men: A multi-center study', Yonsei medical journal, vol. 52, no. 1, pp. 74-80. https://doi.org/10.3349/ymj.2011.52.1.74

Nomogram to predict insignificant prostate cancer at radical prostatectomy in korean men : A multi-center study. / Chung, Jae Seung; Choi, Han Yong; Song, Hae Ryoung; Byun, Seok Soo; Seo, Seong Il; Song, Cheryn; Cho, Jin Seon; Lee, Sang Eun; Ahn, Hanjong; Lee, Eun Sik; Hwang, Tae Kon; Kim, Wun Jae; Chung, Moon Kee; Jung, Tae Young; Yu, Ho Song; Choi, Young Deuk.

In: Yonsei medical journal, Vol. 52, No. 1, 01.01.2011, p. 74-80.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Nomogram to predict insignificant prostate cancer at radical prostatectomy in korean men

T2 - A multi-center study

AU - Chung, Jae Seung

AU - Choi, Han Yong

AU - Song, Hae Ryoung

AU - Byun, Seok Soo

AU - Seo, Seong Il

AU - Song, Cheryn

AU - Cho, Jin Seon

AU - Lee, Sang Eun

AU - Ahn, Hanjong

AU - Lee, Eun Sik

AU - Hwang, Tae Kon

AU - Kim, Wun Jae

AU - Chung, Moon Kee

AU - Jung, Tae Young

AU - Yu, Ho Song

AU - Choi, Young Deuk

PY - 2011/1/1

Y1 - 2011/1/1

N2 - 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.

AB - 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.

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