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A pretreatment nomogram predicting biochemical failure after salvage cryotherapy for locally recurrent prostate cancer
Author(s) -
Spiess Philippe E.,
Katz Aaron E.,
Chin Joseph L.,
Bahn Duke,
Cohen Jeffrey K.,
Shinohara Katsuto,
Hernandez Mike,
Bossier Julie,
Kassouf Wassim,
Pisters Louis L.
Publication year - 2010
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2009.09078.x
Subject(s) - medicine , nomogram , prostate cancer , cryotherapy , stage (stratigraphy) , prostate specific antigen , retrospective cohort study , concordance , biopsy , surgery , logistic regression , clinical endpoint , cohort , cancer , clinical trial , paleontology , biology
Study Type – Prognosis (retrospective cohort)
Level of Evidence 2b OBJECTIVE To gather a pooled database from six tertiary‐care referral centres using salvage cryotherapy (SC) for locally recurrent prostate cancer, and develop a pretreatment nomogram allowing a prediction of the probability of biochemical failure after SC, based on pretreatment clinical variables. PATIENTS AND METHODS We retrospectively analysed 797 men treated at six tertiary‐care referral centres with SC for locally recurrent disease after primary radiotherapy with curative intent. The median duration of follow‐up from the time of SC to the date of last contact was 3.4 years. The primary study endpoint was biochemical failure, defined as a serum prostate‐specific antigen (PSA) level after SC of >0.5 ng/mL. RESULTS Overall, the rate of biochemical failure was 66% with a median of 3.4 years of follow‐up. A logistic regression model was used to predict biochemical failure. Covariates included serum PSA level at diagnosis, initial clinical T stage, and initial biopsy Gleason score. On the basis of these results, a pretreatment nomogram was developed which can be used to help select patients best suited for SC. Our pretreatment nomogram was internally validated using 500 bootstrap samples, with the concordance index of the model being 0.70. CONCLUSION A pretreatment nomogram based on several diagnostic variables (serum PSA level at diagnosis, biopsy Gleason grade, and initial clinical T stage) was developed and might allow the selection of ideal candidates for SC.