title: A nomogram predicting 10-year life expectancy in candidates for radical prostatectomy or radiotherapy for prostate cancer.
abstract: OBJECTIVE
  Candidates for definitive therapy for localized prostate cancer (PCa) should have life expectancy (LE) in excess of 10 years. However, LE estimation is difficult. To circumvent this problem, we developed a nomogram predicting 10-year LE for patients treated with either radical prostatectomy (RP) or external-beam radiation therapy (EBRT) and compared it with an existing tool.
  
  
  METHODS
  Between 1989 and 2000, 9,131 men were treated with either RP (n = 5,955) or EBRT (n = 3,176), without any secondary therapy and all deaths were considered unrelated to PCa. Age and Charlson comorbidity index (CCI) predicted 10-year LE in Cox regression models. We used 200 bootstrap resamples to internally validate the nomogram.
  
  
  RESULTS
  Median age was 66 years, median CCI was 1, median follow-up was 5.9 years and median actuarial survival was 13.8 years. Advanced age (P < .001), elevated CCI score (P < .001) and treatment type (EBRT v RP, P < .001) were independent predictors of poor 10 year LE. The nomogram predicting 10 year LE after either RP or EBRT was 84.3% accurate in split sample validation and was 2.9% (P = .007) more accurate than the existing tool. A cutoff of 70% or less was 84% accurate in identifying men who did not survive beyond 10 years.
  
  
  CONCLUSIONS
  Our nomogram can accurately identify those individuals who do not have sufficient LE to warrant definitive PCa treatment and can help optimizing therapy decision-making.
authors: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montréal, Québec, Canada.
authors: Jochen
authors: J
authors: Walz
authors: Andrea
authors: A
authors: Gallina
authors: Fred
authors: F
authors: Saad
authors: Francesco
authors: F
authors: Montorsi
authors: Paul
authors: P
authors: Perrotte
authors: Shahrokh F
authors: SF
authors: Shariat
authors: Claudio
authors: C
authors: Jeldres
authors: Markus
authors: M
authors: Graefen
authors: Francois
authors: F
authors: Bénard
authors: Michael
authors: M
authors: McCormack
authors: Luc
authors: L
authors: Valiquette
authors: Pierre I
authors: PI
authors: Karakiewicz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D006801:Humans; D008017:Life Expectancy; D008297:Male; D015233:Models, Statistical; D049451:Nomograms; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D015996:Survival Rate