A nomogram predicting 10-year life expectancy in candidates for radical prostatectomy or radiotherapy for prostate cancer.

TY - JOUR

T1 - A nomogram predicting 10-year life expectancy in candidates for radical prostatectomy or radiotherapy for prostate cancer.

AU - Walz, Jochen

AU - Gallina, Andrea

AU - Saad, Fred

AU - Montorsi, Francesco

AU - Perrotte, Paul

AU - Shariat, Shahrokh F

AU - Jeldres, Claudio

AU - Graefen, Markus

AU - Bénard, Francois

AU - McCormack, Michael

AU - Valiquette, Luc

AU - Karakiewicz, Pierre I

PY - 2007

Y1 - 2007

N2 - PURPOSE: Candidates for definitive therapy for localized prostate cancer (PCa) should have life expectancy (LE) in excess of 10 years. However, LE estimation is difficult. To circumvent this problem, we developed a nomogram predicting 10-year LE for patients treated with either radical prostatectomy (RP) or external-beam radiation therapy (EBRT) and compared it with an existing tool. PATIENTS AND METHODS: Between 1989 and 2000, 9,131 men were treated with either RP (n = 5,955) or EBRT (n = 3,176), without any secondary therapy and all deaths were considered unrelated to PCa. Age and Charlson comorbidity index (CCI) predicted 10-year LE in Cox regression models. We used 200 bootstrap resamples to internally validate the nomogram. RESULTS: Median age was 66 years, median CCI was 1, median follow-up was 5.9 years and median actuarial survival was 13.8 years. Advanced age (P <.001), elevated CCI score (P <.001) and treatment type (EBRT v RP, P <.001) were independent predictors of poor 10 year LE. The nomogram predicting 10 year LE after either RP or EBRT was 84.3% accurate in split sample validation and was 2.9% (P = .007) more accurate than the existing tool. A cutoff of 70% or less was 84% accurate in identifying men who did not survive beyond 10 years. CONCLUSION: Our nomogram can accurately identify those individuals who do not have sufficient LE to warrant definitive PCa treatment and can help optimizing therapy decision-making.

AB - PURPOSE: Candidates for definitive therapy for localized prostate cancer (PCa) should have life expectancy (LE) in excess of 10 years. However, LE estimation is difficult. To circumvent this problem, we developed a nomogram predicting 10-year LE for patients treated with either radical prostatectomy (RP) or external-beam radiation therapy (EBRT) and compared it with an existing tool. PATIENTS AND METHODS: Between 1989 and 2000, 9,131 men were treated with either RP (n = 5,955) or EBRT (n = 3,176), without any secondary therapy and all deaths were considered unrelated to PCa. Age and Charlson comorbidity index (CCI) predicted 10-year LE in Cox regression models. We used 200 bootstrap resamples to internally validate the nomogram. RESULTS: Median age was 66 years, median CCI was 1, median follow-up was 5.9 years and median actuarial survival was 13.8 years. Advanced age (P <.001), elevated CCI score (P <.001) and treatment type (EBRT v RP, P <.001) were independent predictors of poor 10 year LE. The nomogram predicting 10 year LE after either RP or EBRT was 84.3% accurate in split sample validation and was 2.9% (P = .007) more accurate than the existing tool. A cutoff of 70% or less was 84% accurate in identifying men who did not survive beyond 10 years. CONCLUSION: Our nomogram can accurately identify those individuals who do not have sufficient LE to warrant definitive PCa treatment and can help optimizing therapy decision-making.

M3 - SCORING: Zeitschriftenaufsatz

VL - 25

SP - 3576

EP - 3581

JO - J CLIN ONCOL

JF - J CLIN ONCOL

SN - 0732-183X

IS - 24

M1 - 24

ER -