Development of a new nomogram to predict insignificant prostate cancer in patients undergoing radical prostatectomy. (2nd January 2017)

• Record Type: Journal Article
• Authors: Kim, Tae Heon; Jeon, Hwang Gyun; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Choi, Han Yong; Lee, Hyun Moo
• Is Part Of: Scandinavian journal of urology. Volume 51:Number 1(2017)
• Page Start: 27
• Page End: 32
• Publication Date: 2017-01-02
• Subjects: Insignificant -- nomogram -- prostatectomy -- prostatic neoplasm; Urology -- Periodicals; 616.6
• DOI: 10.1080/21681805.2016.1266384
• Languages: English
• ISSNs: 2168-1805

Abstract

Abstract: Objective: The aim of this study was to develop a nomogram to predict the probability of insignificant prostate cancer. Materials and methods: A retrospective analysis was conducted of patients who underwent radical prostatectomy at a Korean hospital between January 2005 and December 2014. Patients with pathologically insignificant prostate cancer were defined as having organ-confined disease with tumor volume less than 0.5 cm³ without Gleason scores of 4 or 5. Multivariable logistic regression analysis with a stepwise selection was used to model the relationship between preoperative characteristics and insignificant prostate cancer, and a nomogram to predict the probability of insignificant prostate cancer was created. Receiver operating characteristics (ROC) analysis was performed to assess the predictive value of the model. Results: The final study population consisted of 1343 patients. Among these patients, insignificant prostate cancer was confirmed in 188 men (14.0%) at the time of prostatectomy. Six independent predictors of insignificant prostate cancer were identified: number of positive cores ( p < 0.001), maximal single core tumor involvement ( p < 0.001), biopsy Gleason score ( p < 0.001), prostate volume ( p = 0.024), patient age ( p < 0.001) and prostate-specific antigen density ( p < 0.001) in the multivariable model. A nomogram to predict insignificant prostate cancer was developed using these six preoperative characteristics. The area under the ROC curve for nomogram predictions was 0.87. Conclusion: The nomogram developed in this paper identifies the probability of insignificant prostate cancer and gives providers more information to guide their clinical decisions.