A nomogram predicting prostate cancer-specific mortality after radical prostatectomy

Christopher R. Porter, Nazareno Suardi, Umberto Capitanio, Georg C. Hutterer, Koichi Kodama, Robert P. Gibbons, Roy Correa, Paul Perrotte, Francesco Montorsi, Pierre I. Karakiewicz

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We describe a model capable of predicting prostate cancer (PCa)-specific mortality up to 20 years after a radical prostatectomy (RP), which can adjust the predictions according to disease-free interval. Patients and Methods: 752 patients were treated with RP for organ-confined PCa. Cox regression modeled the probability of PCa-specific mortality. The significance of the predictors was confirmed in competing risks analyses, which account for other-cause mortality. Results: The mean follow-up was 11.4 years. The 5-, 10-, 15- and 20-year actuarial rates of PCa-specific survival were 99.0, 95.5, 90.9 and 85.7%, respectively. RP Gleason sum (p <0.001), pT stage (p = 0.007), adjuvant radiotherapy (p = 0.03) and age at RP (p = 0.004) represented independent predictors of PCa-specific mortality in the Cox regression model as well as in competing risks regression. Those variables, along with lymph node dissection status (p = 0.4), constituted the nomogram predictors. After 200 bootstrap resamples, the nomogram achieved 82.6, 83.8, 75.0 and 76.3% accuracy in predicting PCa-specific mortality at 5, 10, 15 and 20 years post-RP, respectively. Conclusions: At 20 years, roughly 20% of men treated with RP may succumb to PCa. The current nomogram helps to identify these individuals. Their follow-up or secondary therapies may be adjusted according to nomogram predictions.

Original languageEnglish
Pages (from-to)132-140
Number of pages9
JournalUrologia Internationalis
Volume84
Issue number2
DOIs
Publication statusPublished - Mar 2010

Keywords

  • Cancer-specific mortality
  • Nomogram
  • Prostate cancer
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology

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