A nomogram is more accurate than a regression tree in predicting lymph node invasion in prostate cancer
A nomogram is more accurate than a regression tree in predicting lymph node invasion in prostate cancer
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DOI：
10.1111/j.1464-410x.2007.07321.x
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发表时间：
2008-03-01
影响因子：
4.5
通讯作者：
Karakiewicz, Pierre I.
中科院分区：
文献类型：
--
作者：
Briganti, Alberto;Gallina, Andrea;Karakiewicz, Pierre I.
比较两种工具的性能和判别特性（树结构回归模型和基于逻辑回归的列线图），最近开发用于预测根治性直肠癌切除术（RP）中的淋巴结浸润（LNI），患者和方法该队列包括1525名连续接受RP和双侧盆腔LN夹层（PLND）治疗的男性患者。在欧洲的两个高等教育中心。临床分期，治疗前前列腺特异性抗原（PSA）水平和活检Gleason总和被用来测试回归树和列线图预测LNI的能力。通过受试者工作特征曲线下面积（AUC）定量准确度。对每个参与研究的机构重复所有的分析。AUC列线图的AUC为81%，回归树的AUC为77%（P = 0.007）。当数据根据机构分层时，诺模图的AUC总是高于回归树（汉堡队列：诺模图82.1%vs回归树77.0%，P = 0.002;米兰队列：82.4%vs 75.9%，P = 0.03）。因此，我们建议使用诺模图导出的预测。
OBJECTIVETo compare the performance and discriminant properties of two instruments (a tree-structured regression model and a logistic regression-based nomogram), recently developed to predict lymph node invasion (LNI) at radical prostatectomy (RP), in a contemporary cohort of European patients.PATIENTS AND METHODSThe cohort comprised 1525 consecutive men treated with RP and bilateral pelvic LN dissection (PLND) in two tertiary academic centres in Europe. Clinical stage, pretreatment prostate-specific antigen (PSA) level and biopsy Gleason sum were used to test the ability of the regression tree and the nomogram to predict LNI. Accuracy was quantified by the area under the receiver operating characteristic curve (AUC). All analyses were repeated for each participating institution.RESULTSThe AUC for the nomogram was 81%, vs 77% for the regression tree (P = 0.007). When data were stratified according to institution, the nomogram invariably had a higher AUC than the regression tree (Hamburg cohort: nomogram 82.1% vs regression tree 77.0%, P = 0.002; Milan cohort: 82.4% vs 75.9%, respectively; P = 0.03).CONCLUSIONSNomogram-based predictions of LNI were more accurate than those derived from a regression tree; therefore, we recommend the use of nomogram-derived predictions.