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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >The prostate cancer risk stratification (ProCaRS) project: Recursive partitioning risk stratification analysis
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The prostate cancer risk stratification (ProCaRS) project: Recursive partitioning risk stratification analysis

机译：前列腺癌风险分层（ProCaRS）项目：递归分区风险分层分析

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Background The Genitourinary Radiation Oncologists of Canada (GUROC) published a three-group risk stratification (RS) system to assist prostate cancer decision-making in 2001. The objective of this project is to use the ProCaRS database to statistically model the predictive accuracy and clinical utility of a proposed new multi-group RS schema. Methods The RS analyses utilized the ProCaRS database that consists of 7974 patients from four Canadian institutions. Recursive partitioning analysis (RPA) was utilized to explore the sub-stratification of groups defined by the existing three-group GUROC scheme. 10-fold cross-validated C-indices and the Net Reclassification Index were both used to assess multivariable models and compare the predictive accuracy of existing and proposed RS systems, respectively. Results The recursive partitioning analysis has suggested that the existing GUROC classification system could be altered to accommodate as many as six separate and statistical unique groups based on differences in BFFS (C-index 0.67 and AUC 0.70). GUROC low-risk patients would be divided into new favorable-low and low-risk groups based on PSA ≤6 and PSA >6. GUROC intermediate-risk patients can be subclassified into low-intermediate and high-intermediate groups. GUROC high-intermediate-risk is defined as existing GUROC intermediate-risk with PSA >=10 AND either T2b/c disease or T1T2a disease with Gleason 7. GUROC high-risk patients would be subclassified into an additional extreme-risk group (GUROC high-risk AND (positive cores ≥87.5% OR PSA >30). Conclusions Proposed RS subcategories have been identified by a RPA of the ProCaRS database.
机译：背景技术加拿大泌尿生殖放射肿瘤学家（GUROC）于2001年发布了三组风险分层（RS）系统，以协助前列腺癌的决策。该项目的目的是使用ProCaRS数据库对预测的准确性和临床进行统计学建模提出的新的多组RS模式的实用程序。方法RS分析使用ProCaRS数据库，该数据库由来自加拿大四个机构的7974名患者组成。递归分区分析（RPA）用于探索由现有的三组GUROC方案定义的组的子分层。 10倍交叉验证的C指数和净重分类指数均用于评估多变量模型并分别比较现有和建议的RS系统的预测准确性。结果递归分区分析表明，基于BFFS的差异（C指数0.67和AUC 0.70），可以更改现有的GUROC分类系统以容纳多达六个独立的统计唯一组。根据PSA≤6和PSA> 6，将GUROC低危患者分为新的有利-低危和低危人群。 GUROC中危患者可分为低中和高中组。 GUROC高中危定义为PSA> = 10且存在G2的T2b / c疾病或T1T2a疾病的现有GUROC中危。风险AND（阳性核心≥87.5％或PSA> 30）结论已通过ProCaRS数据库的RPA确定了拟议的RS子类别。

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