International validation of a preoperative nomogram for prostate cancer recurrence after radical prostatectomy.
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International validation of a preoperative nomogram for prostate cancer recurrence after radical prostatectomy. / Graefen, Markus; Karakiewicz, Pierre I; Cagiannos, Ilias; Quinn, David I; Henshall, Susan M; Grygiel, John J; Sutherland, Robert L; Stricker, Phillip D; Klein, Eric; Kupelian, Patrick; Skinner, Donald G; Lieskovsky, Gary; Bochner, Bernard; Huland, Hartwig; Hammerer, Peter G; Haese, Alexander; Erbersdobler, Andreas; Eastham, James A; de Kernion, Jean; Cangiano, Thomas; Schröder, Fritz H; Wildhagen, Mark F; Kwast, van der; Theo, H; Scardino, Peter T; Kattan, Michael W.
In: J CLIN ONCOL, Vol. 20, No. 15, 15, 2002, p. 3206-3212.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - International validation of a preoperative nomogram for prostate cancer recurrence after radical prostatectomy.
AU - Graefen, Markus
AU - Karakiewicz, Pierre I
AU - Cagiannos, Ilias
AU - Quinn, David I
AU - Henshall, Susan M
AU - Grygiel, John J
AU - Sutherland, Robert L
AU - Stricker, Phillip D
AU - Klein, Eric
AU - Kupelian, Patrick
AU - Skinner, Donald G
AU - Lieskovsky, Gary
AU - Bochner, Bernard
AU - Huland, Hartwig
AU - Hammerer, Peter G
AU - Haese, Alexander
AU - Erbersdobler, Andreas
AU - Eastham, James A
AU - de Kernion, Jean
AU - Cangiano, Thomas
AU - Schröder, Fritz H
AU - Wildhagen, Mark F
AU - Kwast, van der
AU - Theo, H
AU - Scardino, Peter T
AU - Kattan, Michael W
PY - 2002
Y1 - 2002
N2 - PURPOSE: We evaluated the predictive accuracy of a recently published preoperative nomogram for prostate cancer that predicts 5-year freedom from recurrence. We applied this nomogram to patients from seven different institutions spanning three continents. METHODS: Clinical data of 6,754 patients were supplied for validation, and 6,232 complete records were used. Nomogram-predicted probabilities of 60-month freedom from recurrence were compared with actual follow-up in two ways. First, areas under the receiver operating characteristic curves (AUCs) were determined for the entire data set according to several variables, including the institution where treatment was delivered. Second, nomogram classification-based risk quadrants were compared with actual Kaplan-Meier plots. RESULTS: The AUC for all institutions combined was 0.75, with individual institution AUCs ranging from 0.67 to 0.83. Nomogram predictions for each risk quadrant were similar to actual freedom from recurrence rates: predicted probabilities of 87% (low-risk group), 64% (intermediate-low-risk group), 39% (intermediate-high-risk group), and 14% (high-risk group) corresponded to actual rates of 86%, 64%, 42%, and 17%, respectively. The use of neoadjuvant therapy, variation in the prostate-specific antigen recurrence definitions between institutions, and minor differences in the way the Gleason grade was reported did not substantially affect the predictive accuracy of the nomogram. CONCLUSION: The nomogram is accurate when applied at international treatment institutions with similar patient selection and management strategies. Despite the potential for heterogeneity in patient selection and management, most predictions demonstrated high concordance with actual observations. Our results demonstrate that accurate predictions may be expected across different patient populations.
AB - PURPOSE: We evaluated the predictive accuracy of a recently published preoperative nomogram for prostate cancer that predicts 5-year freedom from recurrence. We applied this nomogram to patients from seven different institutions spanning three continents. METHODS: Clinical data of 6,754 patients were supplied for validation, and 6,232 complete records were used. Nomogram-predicted probabilities of 60-month freedom from recurrence were compared with actual follow-up in two ways. First, areas under the receiver operating characteristic curves (AUCs) were determined for the entire data set according to several variables, including the institution where treatment was delivered. Second, nomogram classification-based risk quadrants were compared with actual Kaplan-Meier plots. RESULTS: The AUC for all institutions combined was 0.75, with individual institution AUCs ranging from 0.67 to 0.83. Nomogram predictions for each risk quadrant were similar to actual freedom from recurrence rates: predicted probabilities of 87% (low-risk group), 64% (intermediate-low-risk group), 39% (intermediate-high-risk group), and 14% (high-risk group) corresponded to actual rates of 86%, 64%, 42%, and 17%, respectively. The use of neoadjuvant therapy, variation in the prostate-specific antigen recurrence definitions between institutions, and minor differences in the way the Gleason grade was reported did not substantially affect the predictive accuracy of the nomogram. CONCLUSION: The nomogram is accurate when applied at international treatment institutions with similar patient selection and management strategies. Despite the potential for heterogeneity in patient selection and management, most predictions demonstrated high concordance with actual observations. Our results demonstrate that accurate predictions may be expected across different patient populations.
M3 - SCORING: Zeitschriftenaufsatz
VL - 20
SP - 3206
EP - 3212
JO - J CLIN ONCOL
JF - J CLIN ONCOL
SN - 0732-183X
IS - 15
M1 - 15
ER -
