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 |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work