Development of a nomogram model predicting current bone scan positivity in patients treated with androgen-deprivation therapy for prostate cancer.
Development of a nomogram model predicting current bone scan positivity in patients treated with androgen-deprivation therapy for prostate cancer.
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DOI：
10.3389/fonc.2014.00296
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发表时间：
2014
影响因子：
4.7
通讯作者：
Kattan MW
中科院分区：
文献类型：
--
作者：
Gotto GT;Yu C;Bernstein M;Eastham JA;Kattan MW
目的：建立一种预测晚期前列腺癌接受雄激素剥夺治疗（ADT）患者当前骨扫描阳性的nomogram方法；增强临床判断，突出需要额外影像学检查的患者。材料与方法：回顾性分析2000年至2011年在纪念斯隆-凯特琳癌症中心接受ADT治疗的1293例患者的骨扫描记录（常规99mtc显像）。使用多变量逻辑回归分析来确定适合纳入nomogram的变量。使用这些变量确定当前骨扫描阳性的概率，并通过一致性指数量化nomogram预测准确性。结果：共分析2,681例骨扫描记录，阳性结果636例。总体而言，扫描前前列腺特异性抗原（PSA）水平中位数为2.4 ng/ml；中位PSA倍增时间（PSADT）为5.8个月。在阳性扫描时，中位PSA水平为8.2 ng/ml；53%的患者PSA <10 ng/ml；中位PSADT为4.0个月。nomogram包括5个变量：开始ADT后既往阴性骨扫描次数、PSA水平、Gleason分级总和、根治性前列腺切除术和放疗史。拟合图的一致性指数为0.721。这是一项基于有限数据的回顾性研究，研究对象是在一家大型癌症中心接受常规99mTc骨扫描的患者，这种扫描本身就有固有的局限性。结论：这是第一个预测adt治疗前列腺癌患者当前骨扫描阳性的nomogram，具有较高的预测准确性。
Purpose: To develop a nomogram predictive of current bone scan positivity in patients receiving androgen-deprivation therapy (ADT) for advanced prostate cancer; to augment clinical judgment and highlight patients in need of additional imaging investigations. Materials and methods: A retrospective chart review of bone scan records (conventional 99mTc-scintigraphy) of 1,293 patients who received ADT at the Memorial Sloan-Kettering Cancer Center from 2000 to 2011. Multivariable logistic regression analysis was used to identify variables suitable for inclusion in the nomogram. The probability of current bone scan positivity was determined using these variables and the predictive accuracy of the nomogram was quantified by concordance index. Results: In total, 2,681 bone scan records were analyzed and 636 patients had a positive result. Overall, the median pre-scan prostate-specific antigen (PSA) level was 2.4 ng/ml; median PSA doubling time (PSADT) was 5.8 months. At the time of a positive scan, median PSA level was 8.2 ng/ml; 53% of patients had PSA <10 ng/ml; median PSADT was 4.0 months. Five variables were included in the nomogram: number of previous negative bone scans after initiating ADT, PSA level, Gleason grade sum, and history of radical prostatectomy and radiotherapy. A concordance index value of 0.721 was calculated for the nomogram. This was a retrospective study based on limited data in patients treated in a large cancer center who underwent conventional 99mTc bone scans, which themselves have inherent limitations. Conclusion: This is the first nomogram to predict current bone scan positivity in ADT-treated prostate cancer patients, providing high predictive accuracy.