Radical prostatectomy nomograms in black American men: Accuracy and applicability Journal Article


Authors: Bianco, F. J. Jr; Kattan, M. W.; Scardino, P. T.; Powell, I. J.; Pontes, J. E.; Wood, D. P. Jr
Article Title: Radical prostatectomy nomograms in black American men: Accuracy and applicability
Abstract: Purpose: Nomograms have been developed to allow the prediction of disease recurrence based on clinical and pathological parameters in patients with clinically localized prostate cancer. However, they have been constructed using predominantly white American male (CAM) cohorts. We have previously shown that black American males (AAMs) have worse disease-free survival after radical prostatectomy after controlling for known prognostic factors. We tested the accuracy of prognostic nomograms in a population of AAMs with prostate cancer treated with radical prostatectomy. Materials and Methods: We tested the performance of published preoperative and postoperative prognostic nomograms in a cohort of patients treated with radical prostatectomy as monotherapy for localized prostate cancer at Wayne State University in the prostate specific antigen era. Predictions made with the nomogram were stratified by race and compared with actual outcomes. The summary statistic used to evaluate the nomogram was the concordance index. A value of 0.5 indicates no predictive discrimination, whereas a value of 1.0 indicates perfect discrimination. Results: A total of 1,043 patients, including 331 AAMs (32%) and 712 CAMs (68%), comprised the study cohort. Treatment failure was defined as increasing prostate specific antigen, which occurred in 193 patients (18.5%). The preoperative concordance index for CAMs and AAMs was 0.78 and 0.74, respectively (p = 0.8). The postoperative index was 0.85 and 0.83, respectively (p = 0.9) Conclusions: Preoperative and postoperative nomograms can be applied accurately to an individual regardless of race.
Keywords: survival; adult; aged; disease-free survival; major clinical study; cancer recurrence; cancer staging; lymph node dissection; prostate specific antigen; accuracy; neoplasm recurrence, local; risk assessment; prostate cancer; prostate-specific antigen; prostatic neoplasms; prostate; probability; prostatectomy; predictive value of tests; chi-square distribution; nomogram; negro; african continental ancestry group; blacks; humans; prognosis; human; male; priority journal; article
Journal Title: Journal of Urology
Volume: 170
Issue: 1
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2003-07-01
Start Page: 73
End Page: 76
Language: English
DOI: 10.1097/01.ju.0000068037.57553.54
PUBMED: 12796648
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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  1. Peter T Scardino
    671 Scardino
  2. Michael W Kattan
    218 Kattan