title: Nomogram incorporating PSA level to predict cancer-specific survival for men with clinically localized prostate cancer managed without curative intent.
abstract: BACKGROUND
  The prognosis of men with clinically localized prostate cancer is highly variable, and it is difficult to counsel a man who may be considering avoiding, or delaying, aggressive therapy. After collecting data on a large cohort of men who received no initial active prostate cancer therapy, the aim was to develop, and to internally validate, a nomogram for prediction of disease-specific survival.
  
  
  METHODS
  Working with 6 cancer registries within England and numerous hospitals in the region, a population-based cohort of men diagnosed with prostate cancer between 1990 and 1996 was constructed. All men had baseline serum prostate-specific antigen (PSA) measurements, centralized pathologic grading, and centralized review of clinical stage assignment. Based on the clinical and pathologic data from 1911 men, a statistical model was developed and validated that served as the basis for the nomogram. The discrimination and calibration of the nomogram were assessed with use of one-third of the men, who were omitted from modeling and used as a test sample.
  
  
  RESULTS
  The median age of the included men was 70.4 years. The 25th and 75th percentiles of PSA were 7.3 and 32.6 ng/mL respectively, and the median was 15.4 ng/mL. Forty-two percent of the men had high-grade disease. The nomogram predicted well, with a concordance index of 0.73, and had good calibration.
  
  
  CONCLUSIONS
  An accurate tool was developed for predicting the probability that a man with clinically localized prostate cancer will survive his disease for 120 months if the cancer is not treated with curative intent immediately. The tool should be helpful for patient counseling and clinical trial design.
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Kattan
authors.forename: Jack
authors.initials: J
authors.lastname: Cuzick
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Fisher
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Berney
authors.forename: Tim
authors.initials: T
authors.lastname: Oliver
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Foster
authors.forename: Henrik
authors.initials: H
authors.lastname: Møller
authors.forename: Victor
authors.initials: V
authors.lastname: Reuter
authors.forename: Paul
authors.initials: P
authors.lastname: Fearn
authors.forename: James
authors.initials: J
authors.lastname: Eastham
authors.forename: Peter T
authors.initials: PT
authors.lastname: Scardino
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D049451:Nomograms; D011237:Predictive Value of Tests; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000401:mortality*; D016019:Survival Analysis
chemical_list: D017430:Prostate-Specific Antigen