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

作者全名："Zhanghuang, Chenghao; Zhu, Jianjun; Li, Ye; Wang, Jinkui; Ma, Jing; Li, Li; Yao, Zhigang; Ji, Fengming; Wu, Chengchuang; Tang, Haoyu; Xie, Yucheng; Yan, Bing; Yang, Zhen"

作者地址："[Zhanghuang, Chenghao; Yao, Zhigang; Ji, Fengming; Wu, Chengchuang; Tang, Haoyu; Yan, Bing] Kunming Med Univ, Kunming Childrens Hosp, Dept Urol, Childrens Hosp, Kunming, Peoples R China; [Zhanghuang, Chenghao; Zhu, Jianjun; Li, Ye; Yang, Zhen] Kunming Med Univ, Kunming Childrens Hosp, Childrens Hosp, Dept Oncol, Kunming, Peoples R China; [Zhanghuang, Chenghao; Zhu, Jianjun; Li, Ye; Yang, Zhen] Kunming Med Univ, Kunming Childrens Hosp, Yunnan Children Solid Tumor Treatment Ctr, Childrens Hosp, Kunming, Peoples R China; [Zhanghuang, Chenghao; Ma, Jing; Li, Li; Yan, Bing] Kunming Med Univ, Kunming Childrens Hosp, Yunnan Key Lab Childrens Major Dis Res, Childrens Hosp, Kunming, Peoples R China; [Zhanghuang, Chenghao; Ma, Jing; Li, Li; Yan, Bing] Yunnan Clin Med Ctr Pediat Dis, Kunming Childrens Solid Tumor Diag & Treatment Ct, Yunnan Prov Clin Res Ctr Childrens Hlth & Dis, Kunming, Yunnan, Peoples R China; [Zhanghuang, Chenghao; Wang, Jinkui] Chongqing Key Lab Children Urogenital Dev & Tissu, Chongqing 400015, Peoples R China; [Zhanghuang, Chenghao; Wang, Jinkui] Chongqing Key Lab Pediat, Chongqing 400015, Peoples R China; [Zhanghuang, Chenghao; Wang, Jinkui] Minist Educ Key Lab Child Dev & Disorders, Chongqing 400015, Peoples R China; [Zhanghuang, Chenghao; Wang, Jinkui] Natl Clin Res Ctr Child Hlth & Disorders, Chongqing 400015, Peoples R China; [Zhanghuang, Chenghao; Wang, Jinkui] China Int Sci & Technol Cooperat Base Child Dev &, Chongqing 400015, Peoples R China; [Zhanghuang, Chenghao; Wang, Jinkui] Chongqing Med Univ, Dept Urol, Childrens Hosp, Chongqing 400015, Peoples R China; [Ma, Jing] Kunming Med Univ, Kunming Childrens Hosp, Dept Otolaryngol, Childrens Hosp, Kunming, Peoples R China; [Xie, Yucheng] Kunming Med Univ, Kunming Childrens Hosp, Dept Pathol, Childrens Hosp, Kunming, Peoples R China"

通信作者："Yan, B (通讯作者)，Kunming Med Univ, Kunming Childrens Hosp, Dept Urol, Childrens Hosp, Kunming, Peoples R China.; Yang, Z (通讯作者)，Kunming Med Univ, Kunming Childrens Hosp, Childrens Hosp, Dept Oncol, Kunming, Peoples R China.; Yang, Z (通讯作者)，Kunming Med Univ, Kunming Childrens Hosp, Yunnan Children Solid Tumor Treatment Ctr, Childrens Hosp, Kunming, Peoples R China.; Yan, B (通讯作者)，Kunming Med Univ, Kunming Childrens Hosp, Yunnan Key Lab Childrens Major Dis Res, Childrens Hosp, Kunming, Peoples R China.; Yan, B (通讯作者)，Yunnan Clin Med Ctr Pediat Dis, Kunming Childrens Solid Tumor Diag & Treatment Ct, Yunnan Prov Clin Res Ctr Childrens Hlth & Dis, Kunming, Yunnan, Peoples R China."

来源：BMC UROLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001142413100001

JCR分区：Q3

影响因子：2

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Nomogram; SEER; Elderly; Localized; Prostate cancer; CSS; OS

摘要："ObjectiveProstate 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.MethodsData 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.ResultsA 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.ConclusionWe 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."

基金机构："Yunnan Education Department of Science Research Fund [2020 J0228, 2023 J0295]; Kunming City Health Science and Technology Talent ""1000"" training Project [2020- SW (R)-112]; Kunming Health and Health Commission Health Research Project [2020-0201-001]; Open Research Fund of Clinical Research Center for Children's Health and Diseases of Yunnan Province [2022-ETYY-YJ-03]; Department of Science and Technology of Yunnan Province Kunming Medicine Joint Special Program-General Program [202001AY070001-271, 202301AY070001-108]; Kunming Health Personnel Training Project Technology Center Construction Project [2020-SW (T)-15]"

基金资助正文："This study was supported by Yunnan Education Department of Science Research Fund (No. 2020 J0228, 2023 J0295), Kunming City Health Science and Technology Talent ""1000"" training Project (No. 2020- SW (R)-112), Kunming Health and Health Commission Health Research Project (No. 2020-0201-001), Open Research Fund of Clinical Research Center for Children's Health and Diseases of Yunnan Province (No.2022-ETYY-YJ-03), Department of Science and Technology of Yunnan Province Kunming Medicine Joint Special Program-General Program (No. 202001AY070001-271, 202301AY070001-108), and Kunming Health Personnel Training Project Technology Center Construction Project (No. 2020-SW (T)-15). The funding bodies played no role in the study's design and collection, analysis and interpretation of data, and writing the manuscript."