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Predicting the probability of pT3 or higher pathological stage at radical prostatectomy: COVID19-specific considerations

L. Nocera, LF. Stolzenbach, C. Collà Ruvolo, M. Wenzel, C. Wurnschimmel, Z. Tian, G. Gandaglia, N. Fossati, V. Mirone, FKH. Chun, SF. Shariat, M. Graefen, F. Saad, F. Montorsi, A. Briganti, PI. Karakiewicz

. 2022 ; 12 (-) : 990851. [pub] 20221206

Status neindexováno Jazyk angličtina Země Švýcarsko

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc22031100

BACKGROUND: We tested whether a model identifying prostate cancer (PCa) patients at risk of pT3-4/pN1 can be developed for use during COVID19 pandemic, in order to guarantee appropriate treatment to patients harboring advanced disease patients without compromising sustainability of care delivery. METHODS: Within the Surveillance, Epidemiology and End Results database 2010-2016, we identified 27,529 patients with localized PCa and treated with radical prostatectomy. A multivariable logistic regression model predicting presence of pT3-4/pN1 disease was fitted within a development cohort (n=13,977, 50.8%). Subsequently, external validation (n=13,552, 49.2%) and head-to-head comparison with NCCN risk group stratification was performed. RESULTS: In model development, age, PSA, biopsy Gleason Grade Group (GGG) and percentage of positive biopsy cores were independent predictors of pT3-4/pN1 stage. In external validation, prediction of pT3-4/pN1 with novel nomogram was 74% accurate versus 68% for NCCN risk group stratification. Nomogram achieved better calibration and showed net-benefit over NCCN risk group stratification in decision curve analyses. The use of nomogram cut-off of 49% resulted in pT3-4/pN1 rate of 65%, instead of the average 35%. CONCLUSION: The newly developed, externally validated nomogram predicts presence of pT3-4/pN1 better than NCCN risk group stratification and allows to focus radical prostatectomy treatment on individuals at highest risk of pT3-4/pN1.

Citace poskytuje Crossref.org

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$a Nocera, Luigi $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada $u Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
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$a Predicting the probability of pT3 or higher pathological stage at radical prostatectomy: COVID19-specific considerations / $c L. Nocera, LF. Stolzenbach, C. Collà Ruvolo, M. Wenzel, C. Wurnschimmel, Z. Tian, G. Gandaglia, N. Fossati, V. Mirone, FKH. Chun, SF. Shariat, M. Graefen, F. Saad, F. Montorsi, A. Briganti, PI. Karakiewicz
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$a BACKGROUND: We tested whether a model identifying prostate cancer (PCa) patients at risk of pT3-4/pN1 can be developed for use during COVID19 pandemic, in order to guarantee appropriate treatment to patients harboring advanced disease patients without compromising sustainability of care delivery. METHODS: Within the Surveillance, Epidemiology and End Results database 2010-2016, we identified 27,529 patients with localized PCa and treated with radical prostatectomy. A multivariable logistic regression model predicting presence of pT3-4/pN1 disease was fitted within a development cohort (n=13,977, 50.8%). Subsequently, external validation (n=13,552, 49.2%) and head-to-head comparison with NCCN risk group stratification was performed. RESULTS: In model development, age, PSA, biopsy Gleason Grade Group (GGG) and percentage of positive biopsy cores were independent predictors of pT3-4/pN1 stage. In external validation, prediction of pT3-4/pN1 with novel nomogram was 74% accurate versus 68% for NCCN risk group stratification. Nomogram achieved better calibration and showed net-benefit over NCCN risk group stratification in decision curve analyses. The use of nomogram cut-off of 49% resulted in pT3-4/pN1 rate of 65%, instead of the average 35%. CONCLUSION: The newly developed, externally validated nomogram predicts presence of pT3-4/pN1 better than NCCN risk group stratification and allows to focus radical prostatectomy treatment on individuals at highest risk of pT3-4/pN1.
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$a Collà Ruvolo, Claudia $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada $u Department of Urology, University of Naples Federico II, Naples, Italy
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$a Tian, Zhe $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
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$a Gandaglia, Giorgio $u Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
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$a Fossati, Nicola $u Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
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$a Mirone, Vincenzo $u Department of Urology, University of Naples Federico II, Naples, Italy
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$a Chun, Felix K H $u Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
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$a Shariat, Shahrokh F $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Departments of Urology, Weill Cornell Medical College, New York, NY, United States $u Department of Urology, University of Texas Southwestern, Dallas, TX, United States $u Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czechia $u Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia $u Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
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$a Graefen, Markus $u Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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$a Saad, Fred $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
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$a Montorsi, Francesco $u Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
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$a Briganti, Alberto $u Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
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