Pretreatment Nomogram for Prostate-Specific Antigen Recurrence After Radical Prostatectomy or External-Beam Radiation Therapy for Clinically Localized Prostate Cancer

• Published in: Journal of clinical oncology Vol. 17; no. 1; pp. 168 - 172
• Main Authors: D'AMICO, A. V, WHITTINGTON, R, COLEMAN, C. N, MALKOWICZ, S. B, FONDURULIA, J, CHEN, M.-H, KAPLAN, I, BEARD, C. J, TOMASZEWSKI, J. E, RENSHAW, A. A, WEIN, A
• Format: Journal Article
• Language: English
• Published: Baltimore, MD American Society of Clinical Oncology 01-01-1999; Lippincott Williams & Wilkins
• Subjects: Biological and medical sciences; Humans; Lymph Node Excision; Male; Medical sciences; Multivariate Analysis; Nephrology. Urinary tract diseases; Prostate-Specific Antigen - blood; Prostatectomy; Prostatic Neoplasms - blood; Prostatic Neoplasms - radiotherapy; Prostatic Neoplasms - surgery; Regression Analysis; Risk Factors; Tumors of the urinary system; Urinary tract. Prostate gland; Adenocarcinoma; Human; Relapse; Urinary system disease; Prognosis; Prostate disease; Nomogram; Biological marker; Male; Tumoral marker; Malignant tumor; Regression analysis; Radiotherapy; Statistical study; Prostate specific antigen; Cox model; Surgery; Prostatectomy; Male genital diseases; Prostate; Localized
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/jco.1999.17.1.168

To present nomograms providing estimates of prostate-specific antigen (PSA) failure-free survival after radical prostatectomy (RP) or external-beam radiation therapy (RT) for men diagnosed during the PSA era with clinically localized disease.
A Cox regression multivariable analysis was used to determine the prognostic significance of the pretreatment PSA level, 1992 American Joint Committee on Cancer (AJCC) clinical stage, and biopsy Gleason score in predicting the time to posttherapy PSA failure in 1,654 men with T1c,2 prostate cancer managed with either RP or RT.
Pretherapy PSA, AJCC clinical stage, and biopsy Gleason score were independent predictors (P < .0001) of time to posttherapy PSA failure in patients managed with either RP or RT. Two-year PSA failure rates derived from the Cox regression model and bootstrap estimates of the 95% confidence intervals are presented in the format of a nomogram stratified by the pretreatment PSA, AJCC clinical stage, biopsy Gleason score, and local treatment modality.
Men at high risk (> 50%) for early (< or = 2 years) PSA failure could be identified on the basis of the type of local therapy received and the clinical information obtained as part of the routine work-up for localized prostate cancer. Selection of these men for trials evaluating adjuvant systemic and improved local therapies may be justified.