Statistical modeling using preoperative prognostic variables in predicting extracapsular extension and progression after radical prostatectomy for prostate cancer.
OBJECTIVE
To predict the risk of extracapsular extension and postoperative recurrence before radical prostatectomy (RP) for prostate cancer.


METHODS
We performed multivariate Cox regression analysis on preoperative variables in 260 clinically localized prostate cancer patients who underwent RP. With these data, we constructed a relative risk of recurrence (Rr) equation and an equation to predict the probability of extracapsular extension (PECE) before RP.


RESULTS
Rr is calculated as exp[(0.47 x race + 0.14 x PSAST) + (0.13 x worst biopsy Gleason sum) + (1.03 x stage T1c) + (1.55 x stage T2b,c)], where PSAST indicates a sigmoidal transformation of prostate-specific antigen. PECE is calculated as 1/[1 + exp(-Z)], where Z = -2.47 + 0.15 (PSAST) + 0.31 (worst biopsy Gleason sum) + 0.18 (race) + 0.16 (stage T1c) + 0.38 (stage T2b,c).


CONCLUSIONS
These two equations can be used preoperatively to predict the probability of extracapsular disease and the risk of prostate-specific antigen recurrence in patients undergoing RP.
Bauer
J J
JJ
Department of Surgery, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
Connelly
R R
RR
Seterhenn
I A
IA
Srivastava
S
S
McLeod
D G
DG
Moul
J W
JW
D000368:Aged; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000276:immunology / Q000473:pathology* / Q000601:surgery*; D015203:Reproducibility of Results; D012306:Risk; D016019:Survival Analysis
D017430:Prostate-Specific Antigen