Pretreatment nomogram that predicts 5-year probability of metastasis following three-dimensional conformal radiation therapy for localized prostate cancer Journal Article


Authors: Kattan, M. W.; Zelefsky, M. J.; Kupelian, P. A.; Cho, D.; Scardino, P. T.; Fuks, Z.; Leibel, S. A.
Article Title: Pretreatment nomogram that predicts 5-year probability of metastasis following three-dimensional conformal radiation therapy for localized prostate cancer
Abstract: Purpose: There are several nomograms for the patient considering radiation therapy for clinically localized prostate cancer. Because of the questionable clinical implications of prostate-specific antigen (PSA) recurrence, its use as an end point has been criticized in several of these nomograms. The goal of this study was to create and to externally validate a nomogram for predicting the probability that a patient will develop metastasis within 5 years after three-dimensional conformal radiation therapy (CRT). Patients and Methods: We conducted a retrospective, nonrandomized analysis of 1,677 patients treated with three-dimensional CRT at Memorial Sloan-Kettering Cancer Center (MSKCC) from 1988 to 2000. Clinical parameters examined were pretreatment PSA level, clinical stage, and biopsy Gleason sum. Patients were followed until their deaths, and the time at which they developed metastasis was noted. A nomogram for predicting the 5-year probability of developing metastasis was constructed from the MSKCC cohort and validated using the Cleveland Clinic series of 1,626 patients. Results: After three-dimensional CRT, 159 patients developed metastasis. At 5 years, 11 % of patients experienced metastasis by cumulative incidence analysis (95% CI, 9% to 13%). A nomogram constructed from the data gathered from these men showed an excellent ability to discriminate among patients in an external validation data set, as shown by a concordance index of 0.81. Conclusion: A nomogram with reasonable accuracy and discrimination has been constructed and validated using an external data set to predict the probability that a patient will experience metastasis within 5 years after three-dimensional CRT. © 2003 by American Society of Clinical Oncology.
Keywords: adult; controlled study; aged; aged, 80 and over; disease-free survival; middle aged; retrospective studies; major clinical study; adjuvant therapy; cancer radiotherapy; disease free survival; neoadjuvant therapy; cancer staging; methodology; adenocarcinoma; prostate specific antigen; metastasis; proportional hazards models; pathology; retrospective study; risk; prostate cancer; gleason score; prostate-specific antigen; prostatic neoplasms; blood; proportional hazards model; prostate tumor; prostate biopsy; neoplasm metastasis; prediction and forecasting; predictive value of tests; radiotherapy, conformal; computer assisted radiotherapy; nomogram; roc curve; humans; human; male; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 21
Issue: 24
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2003-12-15
Start Page: 4568
End Page: 4571
Language: English
DOI: 10.1200/jco.2003.05.046
PUBMED: 14673043
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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MSK Authors
  1. Daniel Cho
    4 Cho
  2. Zvi Fuks
    292 Fuks
  3. Michael J Zelefsky
    615 Zelefsky
  4. Peter T Scardino
    621 Scardino
  5. Steven A Leibel
    215 Leibel
  6. Michael W Kattan
    218 Kattan