Development and Validation of a Preoperative Nomogram for Predicting Survival of Patients with Locally Advanced Prostate Cancer after Radical Prostatectomy

Abstract

Background: For selected locally advanced prostate cancer (PCa) patients, radical prostatectomy (RP) is one of the first-line treatments. We aimed to develop a preoperative nomogram to identify what kinds of patients can get the most survival benefits after RP. Methods: We conducted analyses with data from the the Surveillance, Epidemiology, and End Results (SEER) database. Univariable and multivariable Cox regression analyses were used to reveal prognostic factors. A nomogram was built by these factors and validated by concordance index (C-index) and calibration curves. Risk stratification was established based on the nomogram. Results: We studied 14185 patients. N stage, Gleason Score, and percent of positive cores were the independent prognostic factors used to construct the nomogram. For validating, in the training cohort, the C-index was 0.779 (95% CI 0.736–0.822), and in the validation cohort, the C-index was 0.773 (95% CI 0.718–0.808). Calibration curves showed that the predicted survival and actual survival were very close. The nomogram performed better over the American Joint Committee on Cancer (AJCC) staging system (C-index 0.779 versus 0.763 for training cohort, and 0.773 versus 0.745 for validation cohort). The new stratification of risk groups based on the nomogram also showed better discrimination than the AJCC staging system. Conclusions: The preoperative nomogram can provide favorable prognosis stratification ability to help clinicians identify patients who are suitable for surgery.

Clinical Characteristics, Risk Classification System, and Web-Based Nomograms for Young and Middle-Aged Patients (Aged Under 50) with Metastatic Cervical Cancer: Based on Seer Database

“…Besides, they perform much better in the accurate prediction of prognosis [18,19] than conventional staging models. Nomograms are now frequently used to predict the risk of illness and the prognosis of malignancies [20][21][22] . In this research, nomograms are used to predict the survival rates of advanced cervical cancer patients (< 50 years of age) after 12, 24, and 36 months.…”