Nomogram for overall survival of patients with progressive metastatic prostate cancer after castration.
Publication/Presentation Date
10-1-2002
Abstract
PURPOSE: To develop a pretreatment prognostic model for survival of patients with progressive metastatic prostate cancer after castration using parameters that are measured during routine clinical management.
PATIENTS AND METHODS: Pretreatment clinical and biochemical determinants from 409 patients enrolled onto 19 consecutive therapeutic protocols from June 1989 through January 2000 were evaluated. The factors selected were age, Karnofsky performance status (KPS), hemoglobin (HGB), prostate-specific antigen (PSA), lactate dehydrogenase (LDH), alkaline phosphatase (ALK), and albumin. These factors were combined in an accelerated failure time regression model to produce a nomogram to predict median, 1-year, and 2-year survival. The nomogram was validated internally and externally using data from a multicenter randomized trial of suramin plus hydrocortisone versus hydrocortisone alone.
RESULTS: The median survival of the entire group was 15.8 months (range, 0.9 to 77.8 months); 87% have died. In multivariable analysis, KPS, HGB, ALK, albumin, and LDH were significantly associated with survival (P < .05), whereas age and PSA were not. All seven factors were included in the nomogram. When applied to the external validation data set, the nomogram achieved a concordance index of 0.67. Calibration plots suggested that the nomogram was well calibrated for all predictions.
CONCLUSION: A nomogram derived from pretreatment parameters that are measured on a routine basis was constructed. It can be used to predict the median, 1-year, and 2-year survival of patients with progressive castrate metastatic disease with reasonable accuracy. The information is useful to assess prognosis, guide treatment selection, and design clinical trials.
Volume
20
Issue
19
First Page
3972
Last Page
3982
ISSN
0732-183X
Published In/Presented At
Smaletz, O., Scher, H. I., Small, E. J., Verbel, D. A., McMillan, A., Regan, K., Kelly, W. K., & Kattan, M. W. (2002). Nomogram for overall survival of patients with progressive metastatic prostate cancer after castration. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 20(19), 3972–3982. https://doi.org/10.1200/JCO.2002.11.021
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
12351594
Department(s)
Administration and Leadership
Document Type
Article