External Validation of a Brazilian Predictive Nomogram for Pathologic Outcomes Following Radical Prostatectomy in Tertiary Teaching Institutions: the USP Nomograms

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art_BASTIAN JUNIOR_External_Validation_of_a_Brazilian_Predictive_Nomogram_for_2014.PDF (812.56 KB)
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2014
DOI
SciELO
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
BRAZILIAN SOC UROL
Autores
CRIPPA, Alexandre
OLIVEIRA FILHO, Getulio Rodrigues de
Citação
INTERNATIONAL BRAZ J UROL, v.40, n.2, p.161-171, 2014
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Purposes: (a) To externally validate the Crippa and colleagues' nomograms combining PSA, percentage of positive biopsy cores (PPBC) and biopsy Gleason score to predict organ-confined disease (OCD) in a contemporary sample of patients treated at a tertiary teaching institution. (b) To adjust such variables, resulting in predictive nomograms for OCD and seminal vesicle invasion (SVI): the USP nomograms. Materials and Methods: The accuracy of Crippa and colleagues' nomograms for OCD prediction was examined in 1002 men submitted to radical prostatectomy between 2005 and 2010 at the University of Sao Paulo (USP). ROC-derived area under the curve (AUC) and Brier scores were used to assess the discriminant properties of nomograms for OCD. Nomograms performance was explored graphically with LOESS smoothing plots. Furthermore, univariate analysis and logistic regression models targeted OCD and SVI. Variables consisted of PSA, PPBC, biopsy Gleason score and clinical stage. The resulted predictive nomograms for OCD and SVI were internally validated with bootstrapping and the same abovementioned procedures. Results: Crippa and colleagues' nomograms for OCD showed ROC AUC = 0.68 (CI: 0.65-0.70), Brier score = 0.17 and overestimation in LOESS plots. USP nomograms for OCD and SVI showed ROC AUC of 0.73 (CI: 0.70-0.76) and 0.77 (CI: 0.73-0.79), respectively, and Brier scores of 0.16 and 0.08, respectively. The LOESS plots showed excellent calibration for OCD and underestimation for SVI. Conclusions: Crippa and colleagues' nomograms showed moderate discrimination and considerable OCD overestimation. USP nomograms showed good discrimination for OCD and SVI, as well as excellent calibration for OCD and SVI underestimation.
Palavras-chave
Prostate, Prostatic Neoplasms, Risk Factors, Nomograms, Models, Statistical
URI
https://observatorio.fm.usp.br/handle/OPI/7314
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/55