The addition of interleukin-6 soluble receptor and transforming growth factor beta1 improves a preoperative nomogram for predicting biochemical progression in patients with clinically localized prostate cancer Journal Article
| Authors: | Kattan, M. W.; Shariat, S. F.; Andrews, B.; Zhu, K.; Canto, E.; Matsumoto, K.; Muramoto, M.; Scardino, P. T.; Ohori, M.; Wheeler, T. M.; Slawin, K. M. |
| Article Title: | The addition of interleukin-6 soluble receptor and transforming growth factor beta1 improves a preoperative nomogram for predicting biochemical progression in patients with clinically localized prostate cancer |
| Abstract: | Purpose: Several preoperative prostate cancer nomograms have been developed that predict risk of progression using pretreatment prostate-specific antigen (PSA) level, clinical stage, and biopsy Gleason grade. We describe the development and performance of a new nomogram. The nomogram adds new markers to the standard clinical predictors that reflect the biologic behavior of prostate cancer: pretreatment plasma levels of interleukin-6 soluble receptor (IL6SR) and transforming growth factor beta, (TGF-β1). Patients and Methods: Between November 7, 1994 and December 22, 1997, 714 patients with stage cT1c to cT3a prostate cancer and no prior therapy were treated with radical prostatectomy at the Methodist Hospital, Houston TX. Plasma levels of IL6SR and TGF-β1 were measured in banked preoperative plasma. With these data, a nomogram was developed to predict the probability of PSA progression within 5 years of surgery. The nomogram was validated with bootstrapping to assess its discrimination and calibration performance. Results: In the multivariable Cox model, PSA (P = .004), IL6SR (P < .001), TGF-β1, (P < .001), primary Gleason grade (P < .002), and secondary Gleason grade (P = .029) were associated with PSA progression, whereas clinical stage (P = .696) was not. The nomogram seemed to be well calibrated and had a bootstrap-corrected area under the receiver operating characteristic curve (ie, concordance index) of 0.83. For comparison, a nomogram that omitted IL6SR and TGF-β1 achieved a concordance index of only 0.75. Conclusion: We found that pretreatment plasma levels of IL6SR and TGF-β1 improved the ability to predict biochemical progression by a prognostically substantial margin. A nomogram including the pretreatment levels of these molecular markers, along with standard clinical markers, has been developed and internally validated. © 2003 by American Society of Clinical Oncology. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; major clinical study; clinical trial; disease course; cancer localization; cancer staging; neoplasm staging; sensitivity and specificity; prostate specific antigen; transforming growth factor beta; interleukin 6 receptor; tumor markers, biological; pathology; tumor marker; prostate cancer; prostate-specific antigen; prostatic neoplasms; preoperative period; prostatectomy; disease progression; prostate tumor; prediction and forecasting; predictive value of tests; interleukin 6; transforming growth factor beta1; biochemistry; nomogram; receptors, interleukin-6; humans; prognosis; human; male; priority journal; article; tgfb1 protein, human |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 21 |
| Issue: | 19 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2003-10-01 |
| Start Page: | 3573 |
| End Page: | 3579 |
| Language: | English |
| DOI: | 10.1200/jco.2003.12.037 |
| PUBMED: | 12913106 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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