Stephenson Andrew J, Scardino Peter T, Eastham James A, Bianco Fernando J, Dotan Zohar A, Fearn Paul A, Kattan Michael W
Department of Urology, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
J Natl Cancer Inst. 2006 May 17;98(10):715-7. doi: 10.1093/jnci/djj190.
An existing preoperative nomogram predicts the probability of prostate cancer recurrence, defined by prostate-specific antigen (PSA), at 5 years after radical prostatectomy based on clinical stage, serum PSA, and biopsy Gleason grade. In an updated and enhanced nomogram, we have extended the predictions to 10 years, added the prognostic information of systematic biopsy results, and enabled the predictions to be adjusted for the year of surgery. Cox regression analysis was used to model the clinical information for 1978 patients treated by two high-volume surgeons from our institution. The nomogram was externally validated on an independent cohort of 1545 patients with a concordance index of 0.79 and was well calibrated with respect to observed outcome. The inclusion of the number of positive and negative biopsy cores enhanced the predictive accuracy of the model. Thus, a new preoperative nomogram provides robust predictions of prostate cancer recurrence up to 10 years after radical prostatectomy.
现有的术前列线图可根据临床分期、血清前列腺特异性抗原（PSA）和活检Gleason分级预测根治性前列腺切除术后5年前列腺癌复发的概率（以PSA定义）。在一个更新和增强的列线图中，我们将预测时间延长至10年，增加了系统活检结果的预后信息，并使预测能够根据手术年份进行调整。使用Cox回归分析对我们机构两位高年资外科医生治疗的1978例患者的临床信息进行建模。该列线图在一个由1545例患者组成的独立队列中进行了外部验证，一致性指数为0.79，并且在观察结果方面校准良好。纳入阳性和阴性活检核心的数量提高了模型的预测准确性。因此，一种新的术前列线图能够对根治性前列腺切除术后长达10年的前列腺癌复发提供可靠的预测。
