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Validation of a pre...
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Gerdtsson, AxelKarolinska Institute,Skåne University Hospital
(author)
Validation of a prediction model for post-chemotherapy fibrosis in nonseminoma patients
- Article/chapterEnglish2023
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LIBRIS-ID:oai:gup.ub.gu.se/328120
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https://gup.ub.gu.se/publication/328120URI
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https://doi.org/10.1111/bju.16040DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:152873591URI
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https://lup.lub.lu.se/record/23f12119-a553-4abf-b19e-bc17dcac5542URI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Objective To validate Vergouwe's prediction model using the Swedish and Norwegian Testicular Cancer Group (SWENOTECA) RETROP database and to define its clinical utility. Materials and methods Vergouwe's prediction model for benign histopathology in post-chemotherapy retroperitoneal lymph node dissection (PCRPLND) uses the following variables: presence of teratoma in orchiectomy specimen; pre-chemotherapy level of alphafetoprotein; b-Human chorionic gonadotropin and lactate dehydrogenase; and lymph node size pre- and postchemotherapy. Our validation cohort consisted of patients included in RETROP, a prospective population-based database of patients in Sweden and Norway with metastatic nonseminoma, who underwent PC-RPLND in the period 2007-2014. Discrimination and calibration analyses were used to validate Vergouwe's prediction model results. Calibration plots were created and a Hosmer-Lemeshow test was calculated. Clinical utility, expressed as opt-out net benefit (NBopt-out), was analysed using decision curve analysis. Results Overall, 284 patients were included in the analysis, of whom 130 (46%) had benign histology after PC-RPLND. Discrimination analysis showed good reproducibility, with an area under the receiver-operating characteristic curve (AUC) of 0.82 (95% confidence interval 0.77-0.87) compared to Vergouwe's prediction model (AUC between 0.77 and 0.84). Calibration was acceptable with no recalibration. Using a prediction threshold of 70% for benign histopathology, NBopt-out was 0.098. Using the model and this threshold, 61 patients would have been spared surgery. However, only 51 of 61 were correctly classified as benign. Conclusions The model was externally validated with good reproducibility. In a clinical setting, the model may identify patients with a high chance of benign histopathology, thereby sparing patients of surgery. However, meticulous follow-up is required.
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Torisson, GustavLund University,Lunds universitet,Klinisk infektionsmedicin,Forskargrupper vid Lunds universitet,Kognitiv sjukdomsforskning,Institutionen för kliniska vetenskaper, Malmö,Medicinska fakulteten,Clinical infection medicine,Lund University Research Groups,Cognitive disorders,Department of Clinical Sciences, Malmö,Faculty of Medicine(Swepub:lu)med-gut
(author)
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Thor, A.Karolinska Institute,Karolinska Institutet,Karolinska University Hospital
(author)
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Grenabo Bergdahl, AnnaGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Sahlgrenska Academy,Sahlgrenska University Hospital(Swepub:gu)xgrena
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Almas, B.Haukeland University Hospital
(author)
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Håkansson, UlfCAPIO närsjukvård AB(Swepub:lu)kir-uha
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Tornblom, M.Karolinska Institute,Visby hospital
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Negaard, H. F. S.Oslo university hospital,UiT The Arctic University of Norway, Tromsø,University Hospital of North Norway
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Glimelius, I.Uppsala University
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Halvorsen, D.St. Olav’s University Hospital
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Karlsdottir, A.Haukeland University Hospital
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Haugnes, H. S.
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Larsen, S. M.Oslo university hospital
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Holmberg, G.Sahlgrenska University Hospital
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Wahlqvist, R.Oslo university hospital
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Tandstad, T.St. Olav’s University Hospital,Norwegian University of Science and Technology
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Cohn-Cedermark, G.Karolinska Institute,Karolinska Institutet,Karolinska University Hospital
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Ståhl, OlofLund University,Lunds universitet,Medicinsk onkologi,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medical oncology,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)kir-ost
(author)
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Kjellman, A.Karolinska Institute,Karolinska Institutet,Karolinska University Hospital
(author)
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Karolinska InstituteSkåne University Hospital
(creator_code:org_t)
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In:Bju International132:3, s. 329-3361464-40961464-410X
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Gerdtsson, Axel
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Torisson, Gustav
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Thor, A.
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Grenabo Bergdahl ...
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Almas, B.
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Håkansson, Ulf
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Tornblom, M.
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Negaard, H. F. S ...
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Glimelius, I.
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Halvorsen, D.
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Karlsdottir, A.
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Haugnes, H. S.
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Larsen, S. M.
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Holmberg, G.
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Wahlqvist, R.
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Tandstad, T.
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Cohn-Cedermark, ...
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Ståhl, Olof
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Kjellman, A.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Urology and Neph ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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Bju Internationa ...
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University of Gothenburg
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Karolinska Institutet
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Lund University