New Nomogram Improves Post-RP Metastasis Predictions
Nomogram based on a cohort of men with high-risk prostate cancer is more accurate than the CAPRA and MSKCC nomograms, researchers report.
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BOSTON—Investigators have developed a preoperative nomogram they believe is more suitable than previous nomograms for predicting metastasis after radical prostatectomy for localized high-risk prostate cancer (PCa), according to a presentation at the American Urological Association 2017 annual meeting.
The nomogram, which incorporates age, ethnicity, PSA level, Gleason grade, clinical stage, and number of positive biopsy cores with Gleason 8–10 disease, has greater predictive accuracy for metastasis than the Cancer of the Prostate Risk Assessment (CAPRA) and Memorial Sloan Kettering Cancer Center (MSKCC) nomograms, Lamont Wilkins, a medical student at the Lerner College of Medicine at the Cleveland Clinic in Ohio, and colleagues reported.
In a collaborative effort, researchers at Cleveland Clinic and Johns Hopkins University in Baltimore developed the nomogram based on findings from a study that included 1241 men who underwent RP from 2005 to 2015 for high-risk (HR) or very-high-risk (VHR) PCa as defined by National Comprehensive Cancer Network criteria. The investigators divided patients into a training cohort of 620 men and a validation cohort of 621 men.
Metastasis developed in 123 men (64 and 59 in the training and validation cohorts, respectively). The metastasis-free probability at 5 years was 86.5%.
The area under the curve (AUC) for predicting metastasis was 0.75 for the new nomogram compared with 0.67 and 0.66 for the CAPRA and MKSCC nomograms, which the investigators noted were developed based on cohorts of primarily low- and intermediate-risk men.
Wilkins L, Alam R, Tosoian JJ, et al. Predicting metastasis in men with localized high risk prostate cancer undergoing radical prostatectomy. [abstract] J Urol 2017;197(4S):e169-e170. Poster presented at the American Urological Association 2017 annual meeting in Boston on May 12, 2017. Poster MP14-19.