Molina Escudero R, Herranz-Amo F, Paez-Borda A, Hernandez Fernandez C
Department of Urology. Hospital Universitario de Fuenlabrada.Department of Urology. Hospital Universitario Gregorio Marañon. Madrid.Spain.
Department of Urology. Hospital Universitario Gregorio Marañon.Madrid.Spain.
Arch Esp Urol. 2014 Apr;67(3):259-67.
To identify the post-prostatectomy prognostic factors of biochemical recurrence (BCR) and develop a predictive model for BCR based on predictive pathological variables after radical prostatectomy (RP).
We retrospectively analysed patients with clinically localised prostate cancer treated with RP as monotherapy with a minimum follow up period of 12 months. We considered BCR to be the persistence or elevation of PSA levels after RP of> 0,4 ng/ml, and rising in the following determination. We performed uni-and multivariate analysis, using the logistic regression test to determine the variables associated with BCR. We developed a mathematical model to estimate BCR, based on the variables identified, with a logistic function equation and then designed an Excel spreadsheet to apply it. Calibration and discrimination were performed by way of a Hosmer-Lemeshow test and an ROC curve.
693 patients were included. Average age was 63.5 years and average follow up was 88.5 months. BCR was observed in 218 patients. The average time to BCR was 35.5 months, and 90% of the cases occurred in the first 7 years. In the multivariate analysis, the PSA, Gleason Score (GS) = 7(4+3), pathological stage pT3b and affectation of the surgical margin (SM) were identified as independent prognostic pathological variables related to BCR (p〈0,001). The above four variables were included into the equation of the model. Specificity and sensitivity were 90.6% and 50.2%. Its predictive capacity was 80.5% (CI 95% 76,80 -84.3).
PSA, GS = 7(4+3), pathological stage pT3b and PSM were found to be the independent prognostic pathological variables related to BCR-free survival. The predictive model developed permits BCR risk estimation with a reliability of 80.5%
确定前列腺切除术后生化复发（BCR）的预后因素，并基于根治性前列腺切除术（RP）后的预测病理变量建立BCR预测模型。
我们回顾性分析了接受RP单药治疗的临床局限性前列腺癌患者，最短随访期为12个月。我们将BCR定义为RP后PSA水平持续或升高至>0.4 ng/ml，并在后续测定中上升。我们进行了单因素和多因素分析，使用逻辑回归检验确定与BCR相关的变量。我们基于所确定的变量，利用逻辑函数方程建立了一个估计BCR的数学模型，然后设计了一个Excel电子表格来应用它。通过Hosmer-Lemeshow检验和ROC曲线进行校准和鉴别。
纳入693例患者。平均年龄为63.5岁，平均随访时间为88.5个月。218例患者出现BCR。BCR的平均时间为35.5个月，90%的病例发生在前7年。在多因素分析中，PSA、Gleason评分（GS）=7（4+3）、病理分期pT3b和手术切缘（SM）受侵犯被确定为与BCR相关的独立预后病理变量（p〈0.001）。上述四个变量被纳入模型方程。特异性和敏感性分别为90.6%和50.2%。其预测能力为80.5%（95%CI 76.80-84.3）。
PSA、GS=7（4+3）、病理分期pT3b和PSM被发现是与无BCR生存相关的独立预后病理变量。所建立的预测模型可对BCR风险进行估计，可靠性为80.5%
