Nomogram for overall survival of patients with progressive metastatic prostate cancer after castration Journal Article
| Authors: | Smaletz, O.; Scher, H. I.; Small, E. J.; Verbel, D. A.; McMillan, A.; Regan, K.; Kelly, W. K.; Kattan, M. W. |
| Article Title: | Nomogram for overall survival of patients with progressive metastatic prostate cancer after castration |
| Abstract: | Purpose: To develop a pretreatment prognostic model for survival of patients with progressive metastatic prostate cancer after castration using parameters that are measured during routine clinical management. Patients and Methods: Pretreatment clinical and biochemical determinants from 409 patients enrolled onto 19 consecutive therapeutic protocols from June 1989 through January 2000 were evaluated. The factors selected were age, Karnofsky performance status (KPS), hemoglobin (HGB), prostate-specific antigen (PSA), lactate dehydrogenase (LDH), alkaline phosphatase (ALK), and albumin. These factors were combined in an accelerated failure time regression model to produce a nomogram to predict median, 1-year, and 2-year survival. The nomogram was validated internally and externally using data from a multicenter randomized trial of suramin plus hydrocortisone versus hydrocortisone alone. Results: The median survival of the entire group was 15.8 months (range, 0.9 to 77.8 months); 87% have died. In multivariable analysis, KPS, HGB, ALK, albumin, and LDH were significantly associated with survival (P < .05), whereas age and PSA were not. All seven factors were included in the nomogram. When applied to the external validation data set, the nomogram achieved a concordance index of 0.67. Calibration plots suggested that the nomogram was well calibrated for all predictions. Conclusion: A nomogram derived from pretreatment parameters that are measured on a routine basis was constructed. It can be used to predict the median, 1-year, and 2-year survival of patients with progressive castrate metastatic disease with reasonable accuracy. The information is useful to assess prognosis, guide treatment selection, and design clinical trials. © 2002 by American Society of Clinical Oncology. |
| Keywords: | adult; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; major clinical study; clinical trial; cancer growth; validation process; prostate specific antigen; metastasis; controlled clinical trial; proportional hazards models; calibration; hemoglobin; prediction; cancer mortality; time; age; prostatic neoplasms; alkaline phosphatase; survival time; albumin; neoplasm metastasis; predictive value of tests; lactate dehydrogenase; multivariate analysis; hydrocortisone; castration; orchiectomy; regression analysis; biochemistry; protein determination; nomogram; suramin; prostate carcinoma; humans; prognosis; human; male; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 20 |
| Issue: | 19 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2002-10-01 |
| Start Page: | 3972 |
| End Page: | 3982 |
| Language: | English |
| DOI: | 10.1200/jco.2002.11.021 |
| PUBMED: | 12351594 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 14 November 2014 -- Source: Scopus |
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