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Nomogram to predict insignificant prostate cancer at radical prostatectomy in Korean men: a multi-center study

 Jae Seung Chung  ;  Han Yong Choi  ;  Hae-Ryoung Song  ;  Seok-Soo Byun  ;  Seong Il Seo  ;  Cheryn Song  ;  Jin Seon Cho  ;  Sang Eun Lee  ;  Hanjong Ahn  ;  Eun Sik Lee  ;  Tae-Kon Hwang  ;  Wun-Jae Kim  ;  Moon Kee Chung  ;  Tae Young Jung  ;  Ho Song Yu  ;  Young Deuk Choi 
 YONSEI MEDICAL JOURNAL, Vol.52(1) : 74-80, 2011 
Journal Title
Issue Date
Aged ; Asian Continental Ancestry Group ; Humans ; Logistic Models ; Male ; Middle Aged ; Nomograms* ; Prostatectomy ; Prostatic Neoplasms/diagnosis* ; Prostatic Neoplasms/surgery
Prostatic neoplasms ; nomograms ; insignificant
PURPOSE: Due to the availability of serum prostate specific antigen (PSA) testing, the detection rate of insignificant prostate cancer (IPC) is increasing. To ensure better treatment decisions, we developed a nomogram to predict the probability of IPC.

MATERIALS AND METHODS: The study population consisted of 1,471 patients who were treated at multiple institutions by radical prostatectomy without neoadjuvant therapy from 1995 to 2008. We obtained nonrandom samples of n = 1,031 for nomogram development, leaving n = 440 for nomogram validation. IPC was defined as pathologic organ-confined disease and a tumor volume of 0.5 cc or less without Gleason grade 4 or 5. Multivariate logistic regression model (MLRM) coefficients were used to construct a nomogram to predict IPC from five variables, including serum prostate specific antigen, clinical stage, biopsy Gleason score, positive cores ratio and maximum % of tumor in any core. The performance characteristics were internally validated from 200 bootstrap resamples to reduce overfit bias. External validation was also performed in another cohort.

RESULTS: Overall, 67 (6.5%) patients had a so-called "insignificant" tumor in nomogram development cohort. PSA, clinical stage, biopsy Gleason score, positive core ratio and maximum % of biopsy tumor represented significant predictors of the presence of IPC. The resulting nomogram had excellent discrimination accuracy, with a bootstrapped concordance index of 0.827.

CONCLUSION: Our current nomogram provides sufficiently accurate information in clinical practice that may be useful to patients and clinicians when various treatment options for screen-detected prostate cancer are considered
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Song, Hae Ryoung(송혜령)
Yu, Ho Song(유호송)
Chung, Jae Seung(정재승)
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
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