Yoneda Kei, Utsumi Takanobu, Somoto Takatoshi, Wakai Ken, Oka Ryo, Endo Takumi, Yano Masashi, Kamiya Naoto, Hiruta Nobuyuki, Suzuki Hiroyoshi
Department of Urology, Toho University Sakura Medical Center, Chiba,Japan.
Department of Urology, Toho University Sakura Medical Center, Chiba, Japan.
Jpn J Clin Oncol. 2018 Feb 1;48(2):195-199. doi: 10.1093/jjco/hyx174.
The present study aimed to validate and compare the predictive accuracies of the Memorial Sloan Kettering Cancer Center (MSKCC) and Johns Hopkins University (JHU) web-based postoperative nomograms for predicting early biochemical recurrence (BCR) after radical prostatectomy (RP) and to analyze clinicopathological factors to predict early BCR after RP using our dataset. The c-index was 0.72 (95% confidence (CI): 0.61-0.83) for the MSKCC nomogram and 0.71 (95% CI: 0.61-0.81) for the and JHU nomogram, demonstrating fair performance in the Japanese population. Furthermore, we statistically analyzed our 174 patients to elucidate prognostic factors for early BCR within 2 years. Lymphovascular invasion (LVI) including lymphatic vessel invasion (ly) was a significant predictor of early BCR in addition to common variables (pT stage, extraprostatic extension, positive surgical margin and seminal vesicle invasion). LVI, particularly ly, may provide a good predictor of early BCR after RP and improve the accuracy of the nomograms.
本研究旨在验证并比较纪念斯隆凯特琳癌症中心(MSKCC)和约翰·霍普金斯大学(JHU)基于网络的术后列线图预测根治性前列腺切除术(RP)后早期生化复发(BCR)的预测准确性,并使用我们的数据集分析预测RP后早期BCR的临床病理因素。MSKCC列线图的c指数为0.72(95%置信区间(CI):0.61 - 0.83),JHU列线图的c指数为0.71(95%CI:0.61 - 0.81),表明在日本人群中表现尚可。此外,我们对174例患者进行了统计分析,以阐明2年内早期BCR的预后因素。除了常见变量(pT分期、前列腺外侵犯、手术切缘阳性和精囊侵犯)外,包括淋巴管侵犯(ly)在内的脉管侵犯(LVI)是早期BCR的重要预测因素。LVI,尤其是ly,可能是RP后早期BCR的良好预测指标,并可提高列线图的准确性。