Miyoshi Yasuhide, Noguchi Kazumi, Yanagisawa Masahiro, Taguri Masataka, Morita Satoshi, Ikeda Ichiro, Fujinami Kiyoshi, Miura Takeshi, Kobayashi Kazuki, Uemura Hiroji
Department of Urology, Yokohama City University Medical Center, Yokohama, Japan.
Department of Urology, Yokohama City University School of Medicine, Yokohama, Japan.
BMC Cancer. 2015 May 1;15:338. doi: 10.1186/s12885-015-1330-x.
We analyzed the relationship between prostate cancer outcomes and pretreatment clinical factors and developed a prognostic nomogram of overall survival (OS) of patients with bone metastasis.
From 1993 to 2011, 463 consecutive patients were treated for bone-metastatic prostate cancer. Data sets from 361 patients were used to develop a nomogram (training data), and data sets of 102 patients were used for validation of the nomogram (validation data). Using the external validation data set, the nomogram was assessed for discriminatory ability, and the predictions were assessed for calibration accuracy by plotting actual survival against predicted risk.
Of the 361 patients in the training data set, 205 (56.8%) patients died, 169 (46.8%) deaths of which were due to prostate cancer. The median follow-up period was 55.2 months. In the multivariate analysis, patient age, serum prostate-specific antigen level, clinical T stage, extent of disease on bone scan, and biopsy Gleason sum were independent prognostic factors. We developed a prognostic model comprising these five factors for patients with bone-metastatic prostate cancer. This nomogram can be used to estimate 1-, 3-, and 5-year survival probability. External validation of this model using 102 validation data sets showed reasonable accuracy (concordance index, 0.719).
Our pretreatment prognostic nomogram might be useful for Japanese patients with bone-metastatic prostate cancer.
我们分析了前列腺癌预后与治疗前临床因素之间的关系，并制定了骨转移患者总生存期（OS）的预后列线图。
1993年至2011年，连续463例患者接受了骨转移性前列腺癌治疗。361例患者的数据集用于制定列线图（训练数据），102例患者的数据集用于验证列线图（验证数据）。使用外部验证数据集评估列线图的鉴别能力，并通过绘制实际生存期与预测风险来评估预测的校准准确性。
训练数据集中的361例患者中，205例（56.8%）死亡，其中169例（46.8%）死于前列腺癌。中位随访期为55.2个月。多因素分析中，患者年龄、血清前列腺特异性抗原水平、临床T分期、骨扫描疾病范围和活检Gleason评分是独立的预后因素。我们为骨转移性前列腺癌患者开发了一个包含这五个因素的预后模型。该列线图可用于估计1年、3年和5年生存概率。使用102个验证数据集对该模型进行外部验证显示出合理的准确性（一致性指数，0.719）。
我们的治疗前预后列线图可能对日本骨转移性前列腺癌患者有用。
