The probability of Gleason score upgrading between biopsy and radical prostatectomy can be accurately predicted

Umberto Capitanio, Pierre I. Karakiewicz, Claudio Jeldres, Alberto Briganti, Andrea Gallina, Nazareno Suardi, Andrea Cestari, Giorgio Guazzoni, Andrea Salonia, Francesco Montorsi

Research output: Contribution to journalArticle

Abstract

The objective of this study was to test the external validity of a previously developed nomogram for the prediction of Gleason score upgrading (GSU) between biopsy and radical prostatectomy (RP). The study population consisted of 973 assessable patients treated with RP at a tertiary care institution. The accuracy of the nomogram was quantified with the receiver operating characteristics curve-derived area under the curve. The performance characteristics (predicted vs observed rate of GSU) were tested within a calibration plot. Overall, GSU was recorded in 39.8% (n = 387) of patients at RP. Of patients with GSU, 70 (18.1%), 23 (5.9%) and 32 (8.3%), respectively, had extracapsular extension, seminal vesicle invasion and lymph node invasion. The accuracy of the nomogram was 74.9% (confidence interval 72.1-77.6%). The model tended to underestimate the observed rate of GSU and the discordance between the predicted and observed rate of GSU ranged from -7 to +10%. The current tool represents the most accurate method of predicting GSU between biopsy and RP. Nonetheless it is not perfect and its performance characteristics should be known prior to its use in clinical decision-making.

Original languageEnglish
Pages (from-to)526-529
Number of pages4
JournalInternational Journal of Urology
Volume16
Issue number5
DOIs
Publication statusPublished - May 2009

Fingerprint

Neoplasm Grading
Prostatectomy
Biopsy
Nomograms
Seminal Vesicles
Tertiary Healthcare
ROC Curve
Calibration
Area Under Curve
Lymph Nodes
Confidence Intervals
Population

Keywords

  • Decision-making
  • Gleason score upgrading
  • Nomogram
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

The probability of Gleason score upgrading between biopsy and radical prostatectomy can be accurately predicted. / Capitanio, Umberto; Karakiewicz, Pierre I.; Jeldres, Claudio; Briganti, Alberto; Gallina, Andrea; Suardi, Nazareno; Cestari, Andrea; Guazzoni, Giorgio; Salonia, Andrea; Montorsi, Francesco.

In: International Journal of Urology, Vol. 16, No. 5, 05.2009, p. 526-529.

Research output: Contribution to journalArticle

@article{4001312ac20d49578167095e62ca460e,
title = "The probability of Gleason score upgrading between biopsy and radical prostatectomy can be accurately predicted",
abstract = "The objective of this study was to test the external validity of a previously developed nomogram for the prediction of Gleason score upgrading (GSU) between biopsy and radical prostatectomy (RP). The study population consisted of 973 assessable patients treated with RP at a tertiary care institution. The accuracy of the nomogram was quantified with the receiver operating characteristics curve-derived area under the curve. The performance characteristics (predicted vs observed rate of GSU) were tested within a calibration plot. Overall, GSU was recorded in 39.8{\%} (n = 387) of patients at RP. Of patients with GSU, 70 (18.1{\%}), 23 (5.9{\%}) and 32 (8.3{\%}), respectively, had extracapsular extension, seminal vesicle invasion and lymph node invasion. The accuracy of the nomogram was 74.9{\%} (confidence interval 72.1-77.6{\%}). The model tended to underestimate the observed rate of GSU and the discordance between the predicted and observed rate of GSU ranged from -7 to +10{\%}. The current tool represents the most accurate method of predicting GSU between biopsy and RP. Nonetheless it is not perfect and its performance characteristics should be known prior to its use in clinical decision-making.",
keywords = "Decision-making, Gleason score upgrading, Nomogram, Radical prostatectomy",
author = "Umberto Capitanio and Karakiewicz, {Pierre I.} and Claudio Jeldres and Alberto Briganti and Andrea Gallina and Nazareno Suardi and Andrea Cestari and Giorgio Guazzoni and Andrea Salonia and Francesco Montorsi",
year = "2009",
month = "5",
doi = "10.1111/j.1442-2042.2009.02270.x",
language = "English",
volume = "16",
pages = "526--529",
journal = "International Journal of Urology",
issn = "0919-8172",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - The probability of Gleason score upgrading between biopsy and radical prostatectomy can be accurately predicted

AU - Capitanio, Umberto

AU - Karakiewicz, Pierre I.

AU - Jeldres, Claudio

AU - Briganti, Alberto

AU - Gallina, Andrea

AU - Suardi, Nazareno

AU - Cestari, Andrea

AU - Guazzoni, Giorgio

AU - Salonia, Andrea

AU - Montorsi, Francesco

PY - 2009/5

Y1 - 2009/5

N2 - The objective of this study was to test the external validity of a previously developed nomogram for the prediction of Gleason score upgrading (GSU) between biopsy and radical prostatectomy (RP). The study population consisted of 973 assessable patients treated with RP at a tertiary care institution. The accuracy of the nomogram was quantified with the receiver operating characteristics curve-derived area under the curve. The performance characteristics (predicted vs observed rate of GSU) were tested within a calibration plot. Overall, GSU was recorded in 39.8% (n = 387) of patients at RP. Of patients with GSU, 70 (18.1%), 23 (5.9%) and 32 (8.3%), respectively, had extracapsular extension, seminal vesicle invasion and lymph node invasion. The accuracy of the nomogram was 74.9% (confidence interval 72.1-77.6%). The model tended to underestimate the observed rate of GSU and the discordance between the predicted and observed rate of GSU ranged from -7 to +10%. The current tool represents the most accurate method of predicting GSU between biopsy and RP. Nonetheless it is not perfect and its performance characteristics should be known prior to its use in clinical decision-making.

AB - The objective of this study was to test the external validity of a previously developed nomogram for the prediction of Gleason score upgrading (GSU) between biopsy and radical prostatectomy (RP). The study population consisted of 973 assessable patients treated with RP at a tertiary care institution. The accuracy of the nomogram was quantified with the receiver operating characteristics curve-derived area under the curve. The performance characteristics (predicted vs observed rate of GSU) were tested within a calibration plot. Overall, GSU was recorded in 39.8% (n = 387) of patients at RP. Of patients with GSU, 70 (18.1%), 23 (5.9%) and 32 (8.3%), respectively, had extracapsular extension, seminal vesicle invasion and lymph node invasion. The accuracy of the nomogram was 74.9% (confidence interval 72.1-77.6%). The model tended to underestimate the observed rate of GSU and the discordance between the predicted and observed rate of GSU ranged from -7 to +10%. The current tool represents the most accurate method of predicting GSU between biopsy and RP. Nonetheless it is not perfect and its performance characteristics should be known prior to its use in clinical decision-making.

KW - Decision-making

KW - Gleason score upgrading

KW - Nomogram

KW - Radical prostatectomy

UR - http://www.scopus.com/inward/record.url?scp=65449163032&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=65449163032&partnerID=8YFLogxK

U2 - 10.1111/j.1442-2042.2009.02270.x

DO - 10.1111/j.1442-2042.2009.02270.x

M3 - Article

C2 - 19389085

AN - SCOPUS:65449163032

VL - 16

SP - 526

EP - 529

JO - International Journal of Urology

JF - International Journal of Urology

SN - 0919-8172

IS - 5

ER -