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  • Bjartell, AndersLund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,Urological cancer, Malmö,Lund University Research Groups,Skåne University Hospital,Skane Univ Hosp, Dept Urol, SE-20502 Malmo, Sweden.;Lund Univ, Div Urol Canc, Dept Translat Med, S-22100 Lund, Sweden. (author)

Prediction of clinical progression after radical prostatectomy in a nationwide population-based cohort

  • Article/chapterEnglish2016

Publisher, publication year, extent ...

  • 2016-05-18
  • Medical Journals Sweden AB,2016

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/239654
  • https://gup.ub.gu.se/publication/239654URI
  • https://doi.org/10.1080/21681805.2016.1183226DOI
  • https://lup.lub.lu.se/record/eb016806-2ec2-4f0f-a71e-5bbd42b83b3dURI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-300104URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-124277URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:133879584URI

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  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

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  • Objective: The aim of this study was to create a model for predicting progression-free survival after radical prostatectomy for localized prostate cancer. Material and methods: The risk of biochemical recurrence (BCR) was modelled in a cohort of 3452 men aged 70 years or younger who were primarily treated with radical prostatectomy after being diagnosed between 2003 and 2006 with localized prostate cancer [clinical stage T1c-T2, Gleason score 5-10, N0/NX, M0/MX, prostate-specific antigen (PSA)<20 ng/ml]. The cohort was split into two: one cohort for model development (n = 3452) and one for validation (n = 1762). BCR was defined as two increasing PSA values of at least 0.2 ng/ml, initiation of secondary therapy, distant metastases or death from prostate cancer. Multivariable Cox proportional hazard regression was applied, predictive performance was assessed using the bootstrap resampling technique to calculate the c index, and calibration of the model was evaluated by comparing predicted and observed Kaplan-Meier 1 year BCR. Results: The overall 5 year progression-free survival was 83% after a median follow-up time of 6.8 years in the development cohort and 7.3 years in the validation cohort. The final model included T stage, PSA level, primary and secondary Gleason grade, and number of positive and negative biopsies. The c index for discrimination between high and low risk of recurrence was 0.68. The probability of progression-free survival ranged from 22% to 97% over the range of risk scores in the study population. Conclusions: This model is based on nationwide population-based data and can be used with a fair predictive accuracy to guide decisions on clinical follow-up after prostatectomy. An online calculator for convenient clinical use of the model is available at www.npcr.se/nomogram

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  • Bottai, M.Karolinska Institutet,Karolinska Inst, Inst Environm Med, Unit Biostat, Stockholm, Sweden. (author)
  • Persson, J.Sahlgrenska University Hospital,Sahlgrens Univ Hosp, Dept Cardiothorac Surg, Gothenburg, Sweden. (author)
  • Bratt, OlaLund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,Urological cancer, Malmö,Lund University Research Groups,University of Cambridge,Lund Univ, Div Urol Canc, Dept Translat Med, S-22100 Lund, Sweden.;Cambridge Univ Hosp, Dept Urol, Cambridge, England.(Swepub:lu)urok-obr (author)
  • Damber, Jan-Erik,1949University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Univ Gothenburg, Inst Clin Sci Sahlgrenska Acad, Dept Urol, Gothenburg, Sweden.(Swepub:gu)xdamja (author)
  • Stattin, PärUmeå universitet,Uppsala universitet,Umeå University,Urologkirurgi,Umea Univ, Dept Surg & Perioperat Sci Urol & Androl, Umea, Sweden.,Urologi och andrologi,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden(Swepub:umu)past0003 (author)
  • Akre, O.Karolinska Institutet (author)
  • Urologisk cancerforskning, MalmöForskargrupper vid Lunds universitet (creator_code:org_t)

Related titles

  • In:Scandinavian Journal of Urology: Medical Journals Sweden AB50:4, s. 255-2592168-18052168-1813

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