Sophie Knipper1,2, David Pröwrock3, Zhe Tian4, Hans Heinzer3, Derya Tilki3,5, Pierre Karakiewicz4,6, Markus Graefen3. 1. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. a.knipper@uke.de. 2. Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada. a.knipper@uke.de. 3. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. 4. Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada. 5. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 6. Division of Urology, University of Montréal Hospital Center (CHUM), Montreal, QC, Canada.
Abstract
PURPOSE: Accurate life expectancy prediction is essential in decision-making concerning treatment of clinically localized prostate cancer (PCa). Nomogram predictions are more precise and reproducible than clinician's estimations. The most accurate nomogram addressing 10-year life expectancy in PCa patients has not been externally validated to date. Therefore, we aimed to evaluate the performance of this nomogram in a contemporary external cohort. PATIENTS AND METHODS: For this, we enrolled all consecutive patients, who underwent radical prostatectomy at a single institution between 2005 and 2007. Age at surgery and Charlson Comorbidity Index (CCI) were assessed. PCa-related deaths and patients under 55 years were excluded as indicated by the nomogram. The prediction of 10-year life expectancy was calculated according to the nomogram and compared to actual survival data. Calibration and discrimination were assessed using calibration plots. RESULTS: Overall, 1597 patients were evaluated, with a median age of 64 years (range 55-78 years) at surgery and a median follow-up of 134.4 months (range 0.1-161.7 months). Median CCI was 0 (range 0-10). At 10 years, 134 patients (8.4%) had died of other causes than PCa. The nomogram showed moderate discrimination capacities on receiver-operator characteristic analysis (c-index: 0.64). On calibration curves, the nomogram underestimated the actual life expectancy. CONCLUSION: The performance accuracy of this prediction model was moderate and underestimated 10-year life expectancy of contemporary PCa patients. In conclusion, prediction of life expectancy remains challenging with a continued need for more precise tools.
PURPOSE: Accurate life expectancy prediction is essential in decision-making concerning treatment of clinically localized prostate cancer (PCa). Nomogram predictions are more precise and reproducible than clinician's estimations. The most accurate nomogram addressing 10-year life expectancy in PCa patients has not been externally validated to date. Therefore, we aimed to evaluate the performance of this nomogram in a contemporary external cohort. PATIENTS AND METHODS: For this, we enrolled all consecutive patients, who underwent radical prostatectomy at a single institution between 2005 and 2007. Age at surgery and Charlson Comorbidity Index (CCI) were assessed. PCa-related deaths and patients under 55 years were excluded as indicated by the nomogram. The prediction of 10-year life expectancy was calculated according to the nomogram and compared to actual survival data. Calibration and discrimination were assessed using calibration plots. RESULTS: Overall, 1597 patients were evaluated, with a median age of 64 years (range 55-78 years) at surgery and a median follow-up of 134.4 months (range 0.1-161.7 months). Median CCI was 0 (range 0-10). At 10 years, 134 patients (8.4%) had died of other causes than PCa. The nomogram showed moderate discrimination capacities on receiver-operator characteristic analysis (c-index: 0.64). On calibration curves, the nomogram underestimated the actual life expectancy. CONCLUSION: The performance accuracy of this prediction model was moderate and underestimated 10-year life expectancy of contemporary PCa patients. In conclusion, prediction of life expectancy remains challenging with a continued need for more precise tools.
Entities:
Keywords:
External validation; Life expectancy; Nomogram; Prediction model; Prostate cancer
Authors: Phillip L Ross; Claudia Gerigk; Mithat Gonen; Ofer Yossepowitch; Ilias Cagiannos; Pramod C Sogani; Peter T Scardino; Michael W Kattan Journal: Semin Urol Oncol Date: 2002-05
Authors: Matthew Kent; David F Penson; Peter C Albertsen; Michael Goodman; Ann S Hamilton; Janet L Stanford; Antoinette M Stroup; Behfar Ehdaie; Peter T Scardino; Andrew J Vickers Journal: BMC Med Date: 2016-02-09 Impact factor: 8.775