External validation of two web-based postoperative nomograms predicting the probability of early biochemical recurrence after radical prostatectomy: a retrospective cohort study

Abstract

The present study aimed to validate and compare the predictive accuracies of the Memorial Sloan Kettering Cancer Center (MSKCC) and Johns Hopkins University (JHU) web-based postoperative nomograms for predicting early biochemical recurrence (BCR) after radical prostatectomy (RP) and to analyze clinicopathological factors to predict early BCR after RP using our dataset. The c-index was 0.72 (95% confidence (CI): 0.61-0.83) for the MSKCC nomogram and 0.71 (95% CI: 0.61-0.81) for the and JHU nomogram, demonstrating fair performance in the Japanese population. Furthermore, we statistically analyzed our 174 patients to elucidate prognostic factors for early BCR within 2 years. Lymphovascular invasion (LVI) including lymphatic vessel invasion (ly) was a significant predictor of early BCR in addition to common variables (pT stage, extraprostatic extension, positive surgical margin and seminal vesicle invasion). LVI, particularly ly, may provide a good predictor of early BCR after RP and improve the accuracy of the nomograms.

Incorporating artificial intelligence in urology: Supervised machine learning algorithms demonstrate comparative advantage over nomograms in predicting biochemical recurrence after prostatectomy

“…Of note, the Kattan nomogram evaluated 996 men; 17 the CAPSURE nomogram studied 1012 patients 18 while the JHH nomogram reviewed 1800 patients who underwent RP with localized PCa 19 . While these nomograms had been externally validated by various European and Asian demographics, with concordance indexes ranging from 0.72 to 0.77, 23–25 they did present with some limitations: The Kattan model was based on a single surgeon experience; the CAPSURE nomogram had a short mean follow‐up of 36.5 months, while the JHH nomogram only evaluated four pathological parameters (lymph node, SVI, Gleason score, and PSM). Moreover, these nomograms were created >10 years ago and the changing paradigm of PCa diagnosis today (routine multiparametric MRI coupled with comprehensive targeted and systematic prostate biopsy), the evolution of surgical techniques, and revisions of histopathological recordings might all contribute to better prediction of BCR.…”

Impact of Lymphovascular Invasion on Prognosis in the Patients with Bladder Cancer—Comparison of Transurethral Resection and Radical Cystectomy

“…Lymph node metastasis and distant metastasis were collectively defined as metastasis. Pathological evaluation was performed by two out of three pathologists each as a council system in Toho University Sakura Medical Center using the tumor, node, and metastasis classification system updated in 2009 and the new classification for grading non-invasive urothelial bladder carcinomas proposed by the World Health Organization and the International Society of Urological Pathology in 2004 [7][8][9][10].…”

“…The presence of lymphovascular invasion (LVI) has been suggested to predict poor prognosis of bladder cancer, such as more advanced disease and recurrence, and has been reported as a poor prognostic factor even for other carcinomas [1][2][3][4][5][6][7][8][9][10]. As transurethral resection of bladder tumor (TURBT) is a standard treatment for ≥cT1 bladder cancer, the utility of identifying LVI in specimens of TURBT has been suggested [1][2][3][4][5][6][7][9][10][11][12][13].…”

Performance of a Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography–Derived Risk-Stratification Tool for High-risk and Very High-risk Prostate Cancer

“…Comparison models were chosen as previously validated tools used for risk-stratification and prognostication . These were the Cancer of the Prostate Risk Assessment (CAPRA) groups, the Staging Collaboration for Cancer of the Prostate (STAR-CAP) stage groups, and the Memorial Sloan Kettering Cancer Center (MSKCC) preprostatectomy nomogram for 5-year risk of disease progression …”