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首页> 外文期刊>BJU international >Re-calibration and external validation of an existing nomogram to predict aggressive recurrences after radical prostatectomy.
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Re-calibration and external validation of an existing nomogram to predict aggressive recurrences after radical prostatectomy.

机译：重新校准和对现有诺模图进行外部验证，以预测前列腺癌根治术后的复发性复发。

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OBJECTIVE: To re-calibrate the previously published Duke Prostate Center (DPC) nomogram for the prediction of biochemical recurrence (BCR) after radical prostatectomy (RP) to not only predict overall BCR but also the clinically more relevant endpoint of an aggressive recurrence (i.e. a BCR with a postoperative PSA doubling time (PSADT) of <9 months). PATIENTS AND METHODS: Using the established point-scale system based upon the previously published DPC nomogram, we re-calibrated this point system to predict not just BCR, but also aggressive BCR within 2599 men treated with RP from the DPC database. PSADT was computed on all patients meeting the recurrence definition who had a minimum of two PSA values, separated by at least 3 months, and < or =2 years after recurrence. External validation was performed using data from 1695 men treated with RP within the Shared Equal Access Regional Cancer Hospital (SEARCH) database by calculating the concordance index c and by plotting calibration curves. RESULTS: The median follow-up for patients with no BCR was 56 and 47 months for DPC and SEARCH, respectively. In the DPC modelling cohort and the SEARCH validation cohort, 645 (25%) and 557 (33%) men had BCR, while 83 (3.2%) and 71 (4.2%) patients had an aggressive recurrence. In external validation, predictive accuracy for an aggressive BCR was high (c = 0.83) and the nomogram showed good calibration. CONCLUSIONS: We re-calibrated an existing nomogram to not only predict overall BCR after RP but also aggressive recurrence after RP. Our new tool can provide valuable information for patient counselling and patient selection for adjuvant therapy trials.
机译：目的：重新校准先前发表的杜克前列腺中心（DPC）列线图，以预测前列腺癌根治术（RP）后的生化复发（BCR），不仅可以预测总体BCR，还可以预测临床上与侵袭性复发相关的终点（即术后PSA加倍时间（PSADT）<9个月的BCR）。患者和方法：使用基于先前发布的DPC诺模图建立的点标度系统，我们重新校准了该点系，以预测DPC数据库中接受RP治疗的2599名男性中的BCR以及激进性BCR。对所有符合复发定义且至少有两个PSA值，间隔至少3个月且复发后<或= 2年的患者计算PSADT。通过计算共享指数c并绘制校正曲线，使用共享平等访问区域癌症医院（SEARCH）数据库中来自1695名接受RP治疗的男性的数据进行外部验证。结果：无BCR患者的中位随访DPC和SEARCH分别为56个月和47个月。在DPC建模队列和SEARCH验证队列中，有645名（25％）和557名（​​33％）男性患有BCR，而83名（3.2％）和71名（4.2％）患者具有复发性复发。在外部验证中，积极的BCR的预测准确性很高（c = 0.83），并且列线图显示良好的校准。结论：我们重新校准了现有的列线图，不仅可以预测RP后的总体BCR，还可以预测RP后的积极复发。我们的新工具可以为辅助治疗试验的患者咨询和患者选择提供有价值的信息。

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