Prognostic model for predicting survival in men with hormone-refractory metastatic prostate cancer
Prognostic model for predicting survival in men with hormone-refractory metastatic prostate cancer
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DOI：
10.1200/jco.2003.06.100
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发表时间：
2003-04-01
影响因子：
45.3
通讯作者：
Vogelzang, NJ
中科院分区：
文献类型：
--
作者：
Halabi, S;Small, EJ;Vogelzang, NJ
目的：为了开发和验证一个模型，可用于预测转移性前列腺癌难治性前列腺癌患者（HRPC）的总生存概率，患者和方法：数据从6个癌症和白血病组B协议，在1991年至2001年的研究期间，纳入1,101例转移性前列腺癌难治性前列腺癌合并。使用比例风险模型开发基于预处理因素的多变量模型，并构建预后模型。计算受试者工作特征曲线（ROC）下的面积作为预测辨别的量度。通过比较预测概率与实际生存概率，评估模型预测的校准。一个独立的数据集被用来验证拟合model.Results：最终的模型包括以下因素：乳酸脱氢酶，前列腺特异性抗原，碱性磷酸酶，格里森总和，东部肿瘤协作组的性能状态，血红蛋白，和内脏疾病的存在。ROC曲线下面积为0.68。患者被分为四个风险组之一。我们观察到四个风险组的观察和预测生存概率之间有很好的一致性。第一、第二、第三和第四风险组观察到的中位生存期分别为7.5（95%置信区间[CI]，6.2 - 10.9）、13.4（95% CI，9.7 - 26.3）、18.9（95% CI，16.2 - 26.3）和27.2（95% CI，21.9 - 42.8）个月。相应的中位预测生存时间分别为8.8，13.4，17.4，和22.80为4个危险groups.Conclusion：该模型可用于预测个人的生存概率和分层转移HRPC患者的随机III期临床试验。(C)2003年，美国临床肿瘤学会。
Purpose: To develop and validate a model that can be used to predict the overall survival probability among metastatic hormone-refractory prostate cancer patients (HRPC).Patients and Methods: Data from six Cancer and Leukemia Group B protocols that enrolled 1,101 patients with metastatic hormone-refractory adenocarcinoma of the prostate during the study period from 1991 to 2001 were pooled. The proportional hazards model was used to develop a multivariable model on the basis of pretreatment factors and to construct a prognostic model. The area under the receiver operating characteristic curve (ROC) was calculated as a measure of predictive discrimination. Calibration of the model predictions was assessed by comparing the predicted probability with the actual survival probability. An independent data set was used to validate the fitted model.Results: The final model included the following factors: lactate dehydrogenase, prostate-specific antigen, alkaline phosphatase, Gleason sum, Eastern Cooperative Oncology Group performance status, hemoglobin, and the presence of visceral disease. The area under the ROC curve was 0.68. Patients were classified into one of four risk groups. We observed a good agreement between the observed and predicted survival probabilities for the four risk groups. The observed median survival durations were 7.5 (95% confidence interval [CI], 6.2 to 10.9), 13.4 (95% CI, 9.7 to 26.3), 18.9 (95% CI, 16.2 to 26.3), and 27.2 (95% CI, 21.9 to 42.8) months for the first, second, third, and fourth risk groups, respectively. The corresponding median predicted survival times were 8.8,13.4,17.4, and 22.80 for the four risk groups.Conclusion: This model could be used to predict individual survival probabilities and to stratify metastatic HRPC patients in randomized phase III trials. (C) 2003 by American Society of Clinical Oncology.