Jean-Baptiste Beauval1, Bastien Cabarrou2, Giorgio Gandaglia3, Pierre-Marie Patard1, Adil Ouzzane4, Alexandre de la Taille5, Michel Soulié1, Alberto Briganti6, Guillaume Ploussard7, François Rozet8, Mathieu Roumiguié1. 1. Department of Urology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France. 2. Department of Statistics, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France. 3. Ospedale San Raffaele, Milano, Lombardia, Italy. 4. Centre Hospitalier Regional Universitaire de Lille, Lille, France. 5. Department of Urology, CHU Mondor, Créteil, France. 6. Department of Urology, Vita-Salute University San Raffaele, Milan, Italy. 7. Clinique St Jean du Languedoc, Toulouse, France. 8. Institut Mutualiste Montsouris, Paris, France.
Abstract
OBJECTIVE: To establish an external validation of the new nomogram from Gandaglia et al which provides estimates of the probability of pathological favorable disease in pre-operatively defined intermediate-risk PCa. PATIENTS AND METHODS: Overall, 2928 intermediate-risk PCa patients according to the D'Amico classification undergoing RP and bilateral lymph node dissection in seven academic centres between 2000 and 2011. Pathologically favorable PCa was defined as low-grade organ-confined disease. The Receiver Operating Characteristic (ROC) curve was obtained to quantify the overall accuracy (Area Under the Curve, AUC) of the model to predict specimen-confined (SC) disease. Calibration curve was then constructed to illustrate the relationship between the risk-estimates obtained by the model and the observed proportion of SC disease. Kaplan-Meier method was used for PSA recurrence-free survival (PSA-RFS) assessment. RESULTS: Median age was 68 years. 10.6% patients finally presented pathologically favorable disease characteristics at RP. A higher PSAD (OR = 0.01; 95%CI = 0.00-0.04; P < 0.0001) and percentage of positive cores (OR = 0.97; 95%CI = 0.96-0.98; P < 0.0001) were associated with a reduced probability of favorable disease at RP in multivariate analysis. ROC curve analysis showed strongest accuracy of the model (AUC = 0.82; 95%CI = 0.79-0.84). Favorable PCa had a significantly better PSA recurrence-free survival rates as compared to unfavorable PCa after RP (94.2% vs 74.4% at 4 years, P < 0.0001). CONCLUSIONS: This external validation of the Gandaglia nomogram shows relevant accuracy with one out of ten patients in this intermediate risk PCa group with pathologically proven organ-confined disease. This validated risk calculator can help physician to distinguish favorable intermediate risk PCa that can be treated by conservative approach or safer nerve-sparing surgery.
OBJECTIVE: To establish an external validation of the new nomogram from Gandaglia et al which provides estimates of the probability of pathological favorable disease in pre-operatively defined intermediate-risk PCa. PATIENTS AND METHODS: Overall, 2928 intermediate-risk PCa patients according to the D'Amico classification undergoing RP and bilateral lymph node dissection in seven academic centres between 2000 and 2011. Pathologically favorable PCa was defined as low-grade organ-confined disease. The Receiver Operating Characteristic (ROC) curve was obtained to quantify the overall accuracy (Area Under the Curve, AUC) of the model to predict specimen-confined (SC) disease. Calibration curve was then constructed to illustrate the relationship between the risk-estimates obtained by the model and the observed proportion of SC disease. Kaplan-Meier method was used for PSA recurrence-free survival (PSA-RFS) assessment. RESULTS: Median age was 68 years. 10.6% patients finally presented pathologically favorable disease characteristics at RP. A higher PSAD (OR = 0.01; 95%CI = 0.00-0.04; P < 0.0001) and percentage of positive cores (OR = 0.97; 95%CI = 0.96-0.98; P < 0.0001) were associated with a reduced probability of favorable disease at RP in multivariate analysis. ROC curve analysis showed strongest accuracy of the model (AUC = 0.82; 95%CI = 0.79-0.84). Favorable PCa had a significantly better PSA recurrence-free survival rates as compared to unfavorable PCa after RP (94.2% vs 74.4% at 4 years, P < 0.0001). CONCLUSIONS: This external validation of the Gandaglia nomogram shows relevant accuracy with one out of ten patients in this intermediate risk PCa group with pathologically proven organ-confined disease. This validated risk calculator can help physician to distinguish favorable intermediate risk PCa that can be treated by conservative approach or safer nerve-sparing surgery.
Authors: Olga Dolejsova; Radek Kucera; Radka Fuchsova; Ondrej Topolcan; Hana Svobodova; Ondrej Hes; Viktor Eret; Ladislav Pecen; Milan Hora Journal: Technol Cancer Res Treat Date: 2018-01-01
Authors: Paul Sargos; Nicolas Leduc; Nicolas Giraud; Giorgio Gandaglia; Mathieu Roumiguié; Guillaume Ploussard; Francois Rozet; Michel Soulié; Romain Mathieu; Pierre Mongiat Artus; Tamim Niazi; Vincent Vinh-Hung; Jean-Baptiste Beauval Journal: Front Oncol Date: 2021-02-11 Impact factor: 6.244