External Tertiary-Care-Hospital Validation of the Epidemiological SEER-Based Nomogram Predicting Downgrading in High-Risk Prostate Cancer Patients Treated with Radical Prostatectomy
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External Tertiary-Care-Hospital Validation of the Epidemiological SEER-Based Nomogram Predicting Downgrading in High-Risk Prostate Cancer Patients Treated with Radical Prostatectomy. / Cano Garcia, Cristina; Wenzel, Mike; Piccinelli, Mattia Luca; Hoeh, Benedikt; Landmann, Lea; Tian, Zhe; Humke, Clara; Incesu, Reha-Baris; Köllermann, Jens; Wild, Peter J; Würnschimmel, Christoph; Graefen, Markus; Tilki, Derya; Karakiewicz, Pierre I; Kluth, Luis A; Chun, Felix K H; Mandel, Philipp.
in: DIAGNOSTICS, Jahrgang 13, Nr. 9, 1614, 03.05.2023.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - External Tertiary-Care-Hospital Validation of the Epidemiological SEER-Based Nomogram Predicting Downgrading in High-Risk Prostate Cancer Patients Treated with Radical Prostatectomy
AU - Cano Garcia, Cristina
AU - Wenzel, Mike
AU - Piccinelli, Mattia Luca
AU - Hoeh, Benedikt
AU - Landmann, Lea
AU - Tian, Zhe
AU - Humke, Clara
AU - Incesu, Reha-Baris
AU - Köllermann, Jens
AU - Wild, Peter J
AU - Würnschimmel, Christoph
AU - Graefen, Markus
AU - Tilki, Derya
AU - Karakiewicz, Pierre I
AU - Kluth, Luis A
AU - Chun, Felix K H
AU - Mandel, Philipp
PY - 2023/5/3
Y1 - 2023/5/3
N2 - We aimed to externally validate the SEER-based nomogram used to predict downgrading in biopsied high-risk prostate cancer patients treated with radical prostatectomy (RP) in a contemporary European tertiary-care-hospital cohort. We relied on an institutional tertiary-care database to identify biopsied high-risk prostate cancer patients in the National Comprehensive Cancer Network (NCCN) who underwent RP between January 2014 and December 2022. The model's downgrading performance was evaluated using accuracy and calibration. The net benefit of the nomogram was tested with decision-curve analyses. Overall, 241 biopsied high-risk prostate cancer patients were identified. In total, 51% were downgraded at RP. Moreover, of the 99 patients with a biopsy Gleason pattern of 5, 43% were significantly downgraded to RP Gleason pattern ≤ 4 + 4. The nomogram predicted the downgrading with 72% accuracy. A high level of agreement between the predicted and observed downgrading rates was observed. In the prediction of significant downgrading from a biopsy Gleason pattern of 5 to a RP Gleason pattern ≤ 4 + 4, the accuracy was 71%. Deviations from the ideal predictions were noted for predicted probabilities between 30% and 50%, where the nomogram overestimated the observed rate of significant downgrading. This external validation of the SEER-based nomogram confirmed its ability to predict the downgrading of biopsy high-risk prostate cancer patients and its accurate use for patient counseling in high-volume RP centers.
AB - We aimed to externally validate the SEER-based nomogram used to predict downgrading in biopsied high-risk prostate cancer patients treated with radical prostatectomy (RP) in a contemporary European tertiary-care-hospital cohort. We relied on an institutional tertiary-care database to identify biopsied high-risk prostate cancer patients in the National Comprehensive Cancer Network (NCCN) who underwent RP between January 2014 and December 2022. The model's downgrading performance was evaluated using accuracy and calibration. The net benefit of the nomogram was tested with decision-curve analyses. Overall, 241 biopsied high-risk prostate cancer patients were identified. In total, 51% were downgraded at RP. Moreover, of the 99 patients with a biopsy Gleason pattern of 5, 43% were significantly downgraded to RP Gleason pattern ≤ 4 + 4. The nomogram predicted the downgrading with 72% accuracy. A high level of agreement between the predicted and observed downgrading rates was observed. In the prediction of significant downgrading from a biopsy Gleason pattern of 5 to a RP Gleason pattern ≤ 4 + 4, the accuracy was 71%. Deviations from the ideal predictions were noted for predicted probabilities between 30% and 50%, where the nomogram overestimated the observed rate of significant downgrading. This external validation of the SEER-based nomogram confirmed its ability to predict the downgrading of biopsy high-risk prostate cancer patients and its accurate use for patient counseling in high-volume RP centers.
U2 - 10.3390/diagnostics13091614
DO - 10.3390/diagnostics13091614
M3 - SCORING: Journal article
C2 - 37175005
VL - 13
JO - DIAGNOSTICS
JF - DIAGNOSTICS
SN - 2075-4418
IS - 9
M1 - 1614
ER -