Division of Urologic Surgery, Department of Surgery, and Duke Prostate Center, Duke University School of Medicine, Durham, NC, USA.
Prostate Cancer Prostatic Dis. 2010 Mar;13(1):87-93. doi: 10.1038/pcan.2009.48. Epub 2009 Nov 17.
To evaluate whether race modifies the accuracy of nomograms to predict biochemical recurrence (BCR) after radical prostatectomy among subjects from the Shared Equal Access Regional Cancer Hospital (SEARCH) and Duke Prostate Center (DPC) databases. Retrospective analysis of 1721 and 4511 subjects from the SEARCH and DPC cohorts, respectively. The discrimination accuracy for BCR of seven previously published predictive models was assessed using concordance index and compared between African-American men (AAM) and Caucasian men (CM). AAM represented 44% of SEARCH and 14% of DPC. In both cohorts, AAM were more likely to experience BCR than CM (P<0.01). In SEARCH, the mean concordance index across all seven models was lower in AAM (0.678) than CM (0.715), though the mean difference between CM and AAM was modest (0.037; range 0.015-0.062). In DPC the overall mean concordance index for BCR across all seven nomograms was 0.686. In contrast to SEARCH, the mean concordance index in DPC was higher in AAM (0.717) than CM (0.681), though the mean differences between CM and AAM was modest (-0.036; range -0.078 to -0.004). Across all seven models for predicting BCR, the discriminatory accuracy was better among CM in SEARCH and better among AAM in DPC. The mean difference in discriminatory accuracy of all seven nomograms between AAM and CM was approximately 3-4%. This indicates that currently used predictive models have similar performances among CM and AAM. Therefore, nomograms represent a valid and accurate method to predict BCR regardless of race.
为了评估种族是否会影响预测根治性前列腺切除术后生化复发（BCR）的列线图在 SEARCH 和 Duke 前列腺中心（DPC）数据库中的准确性。对 SEARCH 和 DPC 队列中的 1721 名和 4511 名受试者分别进行回顾性分析。使用一致性指数评估了七个先前发表的预测模型对 BCR 的判别准确性，并比较了非裔美国男性（AAM）和白种人男性（CM）之间的差异。AAM 分别占 SEARCH 和 DPC 的 44%和 14%。在两个队列中，AAM 比 CM 更有可能经历 BCR（P<0.01）。在 SEARCH 中，所有七个模型的平均一致性指数在 AAM（0.678）中均低于 CM（0.715），尽管 CM 和 AAM 之间的平均差异较小（0.037；范围 0.015-0.062）。在 DPC 中，所有七个列线图的整体平均 BCR 一致性指数为 0.686。与 SEARCH 不同，DPC 中的平均一致性指数在 AAM 中（0.717）高于 CM（0.681），尽管 CM 和 AAM 之间的平均差异较小（-0.036；范围-0.078 至-0.004）。在预测 BCR 的所有七个模型中，在 SEARCH 中，CM 的判别准确性更高，而在 DPC 中，AAM 的判别准确性更高。AAM 和 CM 之间所有七个列线图的判别准确性的平均差异约为 3-4%。这表明目前使用的预测模型在 CM 和 AAM 中具有相似的性能。因此，列线图是一种有效的、准确的预测 BCR 的方法，与种族无关。
