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Cancer Resources > Cancer News > Cancer News from Reuters > Reuters Cancer News > 2006 > May
Nomogram predicts prostate cancer recurrence up to 10 years after surgery
Last Updated: 2006-05-30 14:11:01 -0400 (Reuters Health)
NEW YORK (Reuters Health) - A new nomogram accurately predicts the 10-year probability of prostate cancer recurrence after radical prostatectomy, according to a report in the May 17th Journal of the National Cancer Institute.
"We have a new tool available which essentially replaces our old one," Dr. Michael W. Kattan from Cleveland Clinic Foundation, Cleveland, Ohio told Reuters Health. Rather than a 5-year estimate of a man's chances of disease recurrence, "this tool predicts the probability that his cancer will recur, biochemically, within 10 years of surgery."
Dr. Kattan and colleagues extended the prediction of the existing nomogram from 5 to 10 years, added the prognostic information of systematic biopsy results, and enabled the predictions to be adjusted for the year of surgery.
Based on outcomes in about 2000 patients, the nomogram contained PSA, clinical stage, primary and secondary Gleason grade, year of surgery, and number of positive and negative biopsy cores.
In a validation cohort of some 1500 patients, this model performed better than one that did not include systematic biopsy results, the researchers note.
"An added feature of the nomogram is the ability to estimate the probability of recurrence at any point in time from 1 to 10 years after radical prostatectomy," the investigators explain. "The ability to predict the risk of early recurrence may be important for neoadjuvant treatment strategies, because disease recurrence within 2-3 years of radical prostatectomy is associated with an increased risk of metastasis progression and cancer-specific mortality."
The current nomogram "is most appropriate to use in regions where PSA screening is widespread," the authors explain. "The original nomogram may be better suited for use in non-PSA-screened patients given that it has been extensively validated in these populations."
"It is important that patients facing a difficult medical decision have access to the most accurate outcome predictions presently available," Dr. Kattan added. "Those predictions would typically come from a prediction model like a nomogram, whereby the predictions can be tailored to individual patient characteristics."
J Natl Cancer Inst 2006;98:715-717.
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