A nomogram to predict Gleason sum upgrading of clinically diagnosed localized prostate cancer among Chinese patients |
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Authors: | Jin-You Wang Yao Zhu Chao-Fu Wang Shi-Lin Zhang Bo Dai Ding-Wei Ye |
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Institution: | Jin-You Wang(Department of 0ncology, Shanghai Medical college, Fudan University, Shanghai 200032, P. R. China);Yao Zhu(Department of 0ncology, Shanghai Medical college, Fudan University, Shanghai 200032, P. R. China);Chao-Fu Wang(Department of 0ncology, Shanghai Medical college, Fudan University, Shanghai 200032, P. R. China);Shi-Lin Zhang(Department of 0ncology, Shanghai Medical college, Fudan University, Shanghai 200032, P. R. China);Bo Dai(Department of 0ncology, Shanghai Medical college, Fudan University, Shanghai 200032, P. R. China);Ding-Wei Ye(Department of 0ncology, Shanghai Medical college, Fudan University, Shanghai 200032, P. R. China); |
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Abstract: | Although several models have been developed to predict the probability of Gleason sum upgrading between biopsy and radical prostatectomy specimens, most of these models are restricted to prostate-specific antigen screening-detected prostate cancer. This study aimed to build a nomogram for the prediction of Gleason sum upgrading in clinical y diagnosed prostate cancer. The study cohort comprised 269 Chinese prostate cancer patients who underwent prostate biopsy with a minimum of 10 cores and were subsequently treated with radical prostatectomy. Of al included patients, 220 (81.8%) were referred with clinical symptoms. The prostate-specific antigen level, primary and secondary biopsy Gleason scores, and clinical T category were used in a multivariate logistic regression model to predict the probability of Gleason sum upgrading. The developed nomogram was validated internally. Gleason sum upgrading was observed in 90 (33.5%) patients. Our nomogram showed a bootstrap-corrected concordance index of 0.789 and good calibration using 4 readily available variables. The nomogram also demonstrated satisfactory statistical performance for predicting significant upgrading. External validation of the nomogram published by Chun et al. in our cohort showed a marked discordance between the observed and predicted probabilities of Gleason sum upgrading. In summary, a new nomogram to predict Gleason sum upgrading in clinically diagnosed prostate cancer was developed, and it demonstrated good statistical performance upon internal validation. |
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Keywords: | Prostatic neoplasms neoplasm staging nomograms |
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