Document Detail


Pre-treatment nomogram for disease-specific survival of patients with chemotherapy-naive androgen independent prostate cancer.
MedLine Citation:
PMID:  16423446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our objective was to develop a nomogram that predicts the probability of cancer-specific survival in men with untreated androgen-independent prostate cancer (AIPC). METHODS: AIPC was diagnosed in 129 consecutive patients between 1989 and 2002. No patient received cytotoxic chemotherapy. Univariate and multivariate Cox regression models were used to test the association between prostate-specific antigen (PSA) level at initiation of androgen deprivation, PSA doubling time (PSADT), PSA nadir on androgen deprivation therapy (ADT), time from ADT to AIPC, and AIPC-specific mortality. Multivariate regression coefficients were then used to develop a nomogram predicting AIPC-specific survival at 12-60 mo after AIPC diagnosis. Two-hundred bootstrap resamples were used to internally validate the nomogram. RESULTS: AIPC-specific mortality was recorded in 74 of 129 patients (57.4%). Other-cause mortality was recorded in 7 men (5.4%). Median overall survival was 52.0 mo (mean, 36.0 mo) and median AIPC-specific survival was 54.0 mo (mean, 35.0 mo). In univariate regression models, all variables were significant predictors of AIPC-specific survival (p < or = 0.02). In multivariate models, PSADT and time from androgen deprivation to AIPC remained statistically significant (p < or = 0.004). Bootstrap-corrected predictive accuracy of the nomogram was 80.9% versus 74.9% for our previous model. CONCLUSIONS: A nomogram predicting AIPC-specific survival is between 13% and 14% more accurate than previous nomograms and 6% more accurate than tree regression-based predictions obtained from the same data. Moreover, a nomogram approach combines several advantages, such as user-friendly interface and precise estimation of individual recurrence probability at several time points after AIPC diagnosis, which all patients deserve to know and all treating physicians need to know.
Authors:
Robert Svatek; Pierre I Karakiewicz; Michael Shulman; Jose Karam; Paul Perrotte; Elie Benaim
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Publication Detail:
Type:  Journal Article     Date:  2006-01-06
Journal Detail:
Title:  European urology     Volume:  49     ISSN:  0302-2838     ISO Abbreviation:  Eur. Urol.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-03-13     Completed Date:  2007-07-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7512719     Medline TA:  Eur Urol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  666-74     Citation Subset:  IM    
Affiliation:
Department of Urology, The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd. J8.112, Dallas, Texas 75390-9110, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Androgen Antagonists / therapeutic use*
Area Under Curve
Humans
Male
Middle Aged
Neoplasm Staging
Nomograms*
Predictive Value of Tests
Probability
Proportional Hazards Models
Prostate-Specific Antigen / blood
Prostatic Neoplasms / blood,  drug therapy*,  mortality*,  pathology
ROC Curve
Retrospective Studies
Survival Analysis
Chemical
Reg. No./Substance:
0/Androgen Antagonists; EC 3.4.21.77/Prostate-Specific Antigen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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