Novel predictive tools for Irish radical prostatectomy pathological outcomes: development and validation

Ir J Med Sci. 2010 Jun;179(2):187-95. doi: 10.1007/s11845-009-0393-6. Epub 2009 Jul 14.

Abstract

Aims: We developed and validated prostate cancer predictive models for Irish patients, allowing individualised predictions of radical prostatectomy pathological outcomes.

Methods: Retrospective review of the Irish Prostate Cancer Research Consortium database from 2003 to 2008 was performed. Two predictive models were formulated: a replica of the Partin tables (n = 169) and a look-up table based on PSA and biopsy Gleason Score (n = 253). Clinico-pathological parameters were compared to the Partin data set. Internal validation was performed.

Results: In total, 70% of patients were at clinical stage T1c. 5.8% had a PSA less than 4.1 ng/ml, whereas 25% of the Partin patients had a PSA in this range. Maximal predictive accuracy was seen for seminal vesicle invasion (area under the curve = 72%). Prediction of extra-prostatic extension and lymph node involvement was only equivalent to that of a chance phenomenon.

Conclusions: Our current results do not support the introduction of the formulated predictive models into routine clinical practice.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Area Under Curve
  • Confidence Intervals
  • Health Status Indicators
  • Humans
  • Ireland
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Nomograms
  • Predictive Value of Tests
  • Prognosis
  • Prostate-Specific Antigen / analysis*
  • Prostatectomy / methods*
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / surgery*
  • ROC Curve
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Treatment Outcome

Substances

  • Prostate-Specific Antigen