Prognostic significance of surgery and radiotherapy in elderly patients with localized prostate cancer: establishing and time-based external validation a nomogram from SEER-based study
Abstract Objective Prostate cancer (PC) is a significant disease affecting men’s health worldwide. More than 60% of patients over 65 years old and more than 80% are diagnosed with localized PC. The current choice of treatment modalities for localized PC and whether overtreatment is controversial. Th...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
|
| Series: | BMC Urology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12894-023-01384-6 |
| _version_ | 1797362871755079680 |
|---|---|
| author | Chenghao Zhanghuang Jianjun Zhu Ye Li Jinkui Wang Jing Ma Li Li Zhigang Yao Fengming Ji Chengchuang Wu Haoyu Tang Yucheng Xie Bing Yan Zhen Yang |
| author_facet | Chenghao Zhanghuang Jianjun Zhu Ye Li Jinkui Wang Jing Ma Li Li Zhigang Yao Fengming Ji Chengchuang Wu Haoyu Tang Yucheng Xie Bing Yan Zhen Yang |
| author_sort | Chenghao Zhanghuang |
| collection | DOAJ |
| description | Abstract Objective Prostate cancer (PC) is a significant disease affecting men’s health worldwide. More than 60% of patients over 65 years old and more than 80% are diagnosed with localized PC. The current choice of treatment modalities for localized PC and whether overtreatment is controversial. Therefore, we wanted to construct a nomogram to predict the risk factors associated with cancer-specific survival (CSS) and overall survival (OS) in elderly patients with localized PC while assessing the survival differences in surgery and radiotherapy for elderly patients with localized PC. Methods Data of patients with localized PC over 65 years were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression models were used to determine independent risk factors for CSS and OS. Nomograms predicting CSS and OS were built using multivariate Cox regression models. The consistency index (C-index), the area under the subject operating characteristic curve (AUC), and the calibration curve were used to test the accuracy and discrimination of the prediction model. Decision curve analysis (DCA) was used to test the potential clinical value of this model. Results A total of 90,434 patients over 65 years and diagnosed with localized PC from 2010 to 2018 were included in the study. All patients were randomly assigned to the training set (n = 63,328) and the validation set (n = 27,106). Univariate and multivariate Cox regression model analysis showed that age, race, marriage, T stage, surgical, radiotherapy, prostate-specific antigen (PSA), and Gleason score (GS) were independent risk factors for predicting CSS in elderly patients with localized PC. Age, race, marriage, surgery, radiotherapy, PSA, and GS were independent risk factors for predicting OS in elderly patients with localized PC. The c-index of the training and validation sets for the predicted CSS is 0.802(95%CI:0.788–0.816) and 0.798(95%CI:0.776–0.820, respectively). The c-index of the training and validation sets for predicting OS is 0.712(95%:0.704–0.720) and 0.724(95%:0.714–0.734). It shows that the nomograms have excellent discriminatory ability. The AUC and the calibration curves also show good accuracy and discriminability. Conclusion We have developed new nomograms to predict CSS and OS in elderly patients with localized PC. After internal validation and external temporal validation with reasonable accuracy, reliability and potential clinical value, the model can be used for clinically assisted decision-making. |
| first_indexed | 2024-03-08T16:13:39Z |
| format | Article |
| id | doaj.art-b8b446c8fcc14bfab443a0ea70061630 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-03-08T16:13:39Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-b8b446c8fcc14bfab443a0ea700616302024-01-07T12:48:53ZengBMCBMC Urology1471-24902024-01-0124111610.1186/s12894-023-01384-6Prognostic significance of surgery and radiotherapy in elderly patients with localized prostate cancer: establishing and time-based external validation a nomogram from SEER-based studyChenghao Zhanghuang0Jianjun Zhu1Ye Li2Jinkui Wang3Jing Ma4Li Li5Zhigang Yao6Fengming Ji7Chengchuang Wu8Haoyu Tang9Yucheng Xie10Bing Yan11Zhen Yang12Department of Urology, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University)Department of Oncology; Yunnan Children solid Tumor Treatment Center, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University), Kunming Children’s Solid Tumor Diagnosis and Treatment CenterDepartment of Oncology; Yunnan Children solid Tumor Treatment Center, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University), Kunming Children’s Solid Tumor Diagnosis and Treatment CenterChongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Chongqing Key Laboratory of Pediatrics; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Department of Urology, Children’s Hospital of Chongqing Medical UniversityYunnan Key Laboratory of Children’s Major Disease Research, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University); Yunnan Province Clinical Research Center for Children’s Health and Disease, Kunming Children’s Solid Tumor Diagnosis and Treatment Center, Yunnan Clinical Medical Center for Pediatric DiseasesYunnan Key Laboratory of Children’s Major Disease Research, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University); Yunnan Province Clinical Research Center for Children’s Health and Disease, Kunming Children’s Solid Tumor Diagnosis and Treatment Center, Yunnan Clinical Medical Center for Pediatric DiseasesDepartment of Urology, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University)Department of Urology, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University)Department of Urology, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University)Department of Urology, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University)Department of Pathology, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University)Department of Urology, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University)Department of Oncology; Yunnan Children solid Tumor Treatment Center, Kunming Children’s Hospital (Children’s Hospital affiliated to Kunming Medical University), Kunming Children’s Solid Tumor Diagnosis and Treatment CenterAbstract Objective Prostate cancer (PC) is a significant disease affecting men’s health worldwide. More than 60% of patients over 65 years old and more than 80% are diagnosed with localized PC. The current choice of treatment modalities for localized PC and whether overtreatment is controversial. Therefore, we wanted to construct a nomogram to predict the risk factors associated with cancer-specific survival (CSS) and overall survival (OS) in elderly patients with localized PC while assessing the survival differences in surgery and radiotherapy for elderly patients with localized PC. Methods Data of patients with localized PC over 65 years were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression models were used to determine independent risk factors for CSS and OS. Nomograms predicting CSS and OS were built using multivariate Cox regression models. The consistency index (C-index), the area under the subject operating characteristic curve (AUC), and the calibration curve were used to test the accuracy and discrimination of the prediction model. Decision curve analysis (DCA) was used to test the potential clinical value of this model. Results A total of 90,434 patients over 65 years and diagnosed with localized PC from 2010 to 2018 were included in the study. All patients were randomly assigned to the training set (n = 63,328) and the validation set (n = 27,106). Univariate and multivariate Cox regression model analysis showed that age, race, marriage, T stage, surgical, radiotherapy, prostate-specific antigen (PSA), and Gleason score (GS) were independent risk factors for predicting CSS in elderly patients with localized PC. Age, race, marriage, surgery, radiotherapy, PSA, and GS were independent risk factors for predicting OS in elderly patients with localized PC. The c-index of the training and validation sets for the predicted CSS is 0.802(95%CI:0.788–0.816) and 0.798(95%CI:0.776–0.820, respectively). The c-index of the training and validation sets for predicting OS is 0.712(95%:0.704–0.720) and 0.724(95%:0.714–0.734). It shows that the nomograms have excellent discriminatory ability. The AUC and the calibration curves also show good accuracy and discriminability. Conclusion We have developed new nomograms to predict CSS and OS in elderly patients with localized PC. After internal validation and external temporal validation with reasonable accuracy, reliability and potential clinical value, the model can be used for clinically assisted decision-making.https://doi.org/10.1186/s12894-023-01384-6NomogramSEERElderlyLocalizedProstate cancerCSS |
| spellingShingle | Chenghao Zhanghuang Jianjun Zhu Ye Li Jinkui Wang Jing Ma Li Li Zhigang Yao Fengming Ji Chengchuang Wu Haoyu Tang Yucheng Xie Bing Yan Zhen Yang Prognostic significance of surgery and radiotherapy in elderly patients with localized prostate cancer: establishing and time-based external validation a nomogram from SEER-based study BMC Urology Nomogram SEER Elderly Localized Prostate cancer CSS |
| title | Prognostic significance of surgery and radiotherapy in elderly patients with localized prostate cancer: establishing and time-based external validation a nomogram from SEER-based study |
| title_full | Prognostic significance of surgery and radiotherapy in elderly patients with localized prostate cancer: establishing and time-based external validation a nomogram from SEER-based study |
| title_fullStr | Prognostic significance of surgery and radiotherapy in elderly patients with localized prostate cancer: establishing and time-based external validation a nomogram from SEER-based study |
| title_full_unstemmed | Prognostic significance of surgery and radiotherapy in elderly patients with localized prostate cancer: establishing and time-based external validation a nomogram from SEER-based study |
| title_short | Prognostic significance of surgery and radiotherapy in elderly patients with localized prostate cancer: establishing and time-based external validation a nomogram from SEER-based study |
| title_sort | prognostic significance of surgery and radiotherapy in elderly patients with localized prostate cancer establishing and time based external validation a nomogram from seer based study |
| topic | Nomogram SEER Elderly Localized Prostate cancer CSS |
| url | https://doi.org/10.1186/s12894-023-01384-6 |
| work_keys_str_mv | AT chenghaozhanghuang prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT jianjunzhu prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT yeli prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT jinkuiwang prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT jingma prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT lili prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT zhigangyao prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT fengmingji prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT chengchuangwu prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT haoyutang prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT yuchengxie prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT bingyan prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy AT zhenyang prognosticsignificanceofsurgeryandradiotherapyinelderlypatientswithlocalizedprostatecancerestablishingandtimebasedexternalvalidationanomogramfromseerbasedstudy |