| PROSTATE CANCER
STAGING TABLES - A PREDICTIVE NOMOGRAM FOR THE UK
Mr Simon R J Bott, Professor John R Masters Prostate Cancer Research Centre, UCL Institute of Urology |
INTRODUCTION
Accurate risk stratification is a pre-requisite to informed decision
making when considering prostate cancer treatments. Most models are
derived from cases managed in the USA. The validity of these methods
maybe compromised when used in a healthcare system other than that
used for generating the predicted outcomes. We present predictive nomograms
derived from the observed outcomes of men treated by radical prostatectomy
(RP) in the UK.
METHODS
Using logistic regression a pilot study identified the best predictors
of pathological stage from eight preoperative variables. All full BAUS
members were asked to submit their consecutive RP patients' age, biopsy
Gleason score, pre operative PSA, number of biopsy cores, number of
biopsy cores containing cancer (% positive cores) and pathological
stage. Nomograms were constructed using this data to predict pT2, pT3a
or pT3b/4/N1 disease after RP and were validated using bootstrapping
techniques.
RESULTS
1913 patients undergoing RP by 39 Consultant Urologists were included.
Using multivariate analysis significant predictors of pathological
stage were preoperative PSA (p<0.0001), biopsy Gleason sum (p<0.0001),
% positive cores (p<0.0001) and age (p<0.001). Nomograms were
constructed based on these variables.
CONCLUSIONS
These nomograms are derived from a large essentially unscreened cohort
from across the country and reflect UK RP patients.
Research summary dated 01 December 2004
Project 2004/04