| Abstract: |
The published nomograms for prediction of pathologic stage at radical prostatecomy are not applicable to patients treated with neoadjuvant hormone therapy (NHT), This retrospective study was performed to develop and validate nomograms for the prediction of pathologic results with radical prostatectomy with or without NHT for use in clinical decision making and patient counseling. There were 1282 consecutive patients with clinical stage T-1a-T-2c prostate cancer undergoing radical prostatectomy with or without NHT between February 1985 and August 1997 for whom all preoperative variables were known. Sixty percent of the patients were randomly chosen to generate the nomograms, and the remaining 40% were used for validation, Pretreatment PSA, biopsy grade, clinical stage, and lack of NHT were statistically significant predictors of extracapsular extension. Pretreatment PSA, biopsy grade, and lack of NHT were statistically significant predictors of seminal vesicle invasion. Only pretreatment PSA was a predictor of nodal metastases, The areas under the receiver-operator characteristic curves for the nomograms were 0.70, 0.80, and 0.78 for the prediction of extracapsular extension, seminal vesicle invasion, and nodal metastases, respectively, The nomograms were validated in a randomly selected independent group of patients. These nomograms aid in clinical decision making and patient counseling regarding the benefit of NHT and radical prostatectomy. |
