Magnetic resonance imaging in the prediction of biochemical recurrence of prostate cancer after radical prostatectomy

OBJECTIVE

To investigate whether magnetic resonance imaging (MRI) findings, when converted into a scoring system, can predict the biochemical recurrence of prostate cancer after radical prostatectomy (RP).

PATIENTS AND METHODS

Between January 2000 and October 2004, 610 patients with biopsy‐confirmed prostate cancer had MRI before RP, with whole‐mount step‐sectioning of the pathology sample. MRI findings were retrospectively scored on a seven‐point scale based on Tumour‐Node‐Mestastasis staging (1, no tumour seen, to 7, lymph node metastasis). MRI scores were added to published 5‐ and 10‐year clinical preoperative nomograms for predicting recurrence. The predictive accuracy of MRI was quantified as the differences in bootstrap‐corrected concordance indices of the models with and without MRI.

RESULTS

As of August 2007, 64 (10.5%) patients had a biochemical recurrence. MRI scores were associated with recurrence (P < 0.001) with hazard ratios of 1.76 and 1.81 in the 5‐ and 10‐year models, respectively. Actual recurrence rates by MRI score were: 1, 0%; 2, 4.5%; 3, 9%; 4, 24.1%; 5, 33.3%; 6, 69.2%; 7, 100%. When MRI was added, the concordance indices of the 5‐ and 10‐year models increased, from 0.762 to 0.776 (P = 0.081) and 0.773 to 0.788 (P = 0.107), respectively; the improvement was not significant.

CONCLUSION

The MRI scoring system devised was a strong predictor of biochemical recurrence after RP. Although MRI did not provide added prognostic value to standard clinical nomograms, in centres where MRI is used routinely, it might increase the confidence of the clinician in assessing the risk of recurrence by contributing supporting data.     

Hypoalbuminemia,Low Base Excess Values,and Tachypnea Predict 28-Day Mortality in Severe Sepsis and Septic Shock Patients in the Emergency Department

PurposeThe objective of this study was to develop a new nomogram that can predict 28-day mortality in severe sepsis and/or septic shock patients using a combination of several biomarkers that are inexpensive and readily available in most emergency departments, with and without scoring systems.ResultsThe prediction model that included albumin, base excess, and respiratory rate demonstrated the largest area under the receiver operating characteristic curve (AUC) value of 0.8173 [95% confidence interval (CI), 0.7605–0.8741]. The logistic analysis revealed that a conventional scoring system was not associated with 28-day mortality. In the validation set, the discrimination of a newly developed nomogram was also good, with an AUC value of 0.7537 (95% CI, 0.6563–0.8512).ConclusionOur new nomogram is valuable in predicting the 28-day mortality of patients with severe sepsis and/or septic shock in the emergency department. Moreover, our readily available nomogram is superior to conventional scoring systems in predicting mortality.     

原发性脑膜瘤一期切除术后复发风险列线图预测模型的构建及验证

目的 构建原发性脑膜瘤患者一期切除术后复发风险的列线图预测模型并进行外部验证。方法 纳入经病理确诊的脑膜瘤患者328例为建模组,构建一期切除术后复发风险的列线图预测模型并进行内部验证;另外纳入同样方式确诊的脑膜瘤患者62例为验证组,对模型进行外部验证;2组均根据术后随访是否复发分为复发组和未复发组。结果 建模组术后复发...     

预测小细胞肺癌一线化疗导致严重中性粒细胞减少的Nomogram的构建

目的 建立一个Nomogram来预测小细胞肺癌一线化疗引起严重中性粒细胞减少(3级或4级)的概率.方法 选择经组织学证实并接受一线化疗的小细胞肺癌患者263例纳入预测队列.在多变量Logistic回归分析中,采用前进法、后退法和逐步法的似然比检验,以最小赤池信息准则值作为停止准则,在此基础上绘制Nomogram;评估其...