doi: 10.5732/cjc.013.10137

A nomogram to predict Gleason sum upgrading of clinically diagnosed localized prostate cancer among Chinese patients

Jin-You Wang, Yao Zhu, Chao-Fu Wang, Shi-Lin Zhang, Bo Dai, Ding-Wei Ye

Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P. R. China

[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 clinically 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 all 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.

Chinese Journal of Cancer 2014, Volume: 33, Issue 5, Page: 241-248

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Jin-You Wang, Yao Zhu, Chao-Fu Wang, Shi-Lin Zhang, Bo Dai, Ding-Wei Ye. A nomogram to predict Gleason sum upgrading of clinically diagnosed localized prostate cancer among Chinese patients. Chin J Cancer. 2014, 33(5):241-248. doi:10.5732/cjc.013.10137


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