title: A nomogram to predict Gleason sum upgrading of clinically diagnosed localized prostate cancer among Chinese patients.
abstract: Although several models have been developed to predict the probability of Gleason sum upgrading between biopsy and radical prostatectomy specimens, most of these models are restricted to prostate-specific antigen screening-detected prostate cancer. This study aimed to build a nomogram for the prediction of Gleason sum upgrading in clinically diagnosed prostate cancer. The study cohort comprised 269 Chinese prostate cancer patients who underwent prostate biopsy with a minimum of 10 cores and were subsequently treated with radical prostatectomy. Of all included patients, 220 (81.8%) were referred with clinical symptoms. The prostate-specific antigen level, primary and secondary biopsy Gleason scores, and clinical T category were used in a multivariate logistic regression model to predict the probability of Gleason sum upgrading. The developed nomogram was validated internally. Gleason sum upgrading was observed in 90 (33.5%) patients. Our nomogram showed a bootstrap-corrected concordance index of 0.789 and good calibration using 4 readily available variables. The nomogram also demonstrated satisfactory statistical performance for predicting significant upgrading. External validation of the nomogram published by Chun et al. in our cohort showed a marked discordance between the observed and predicted probabilities of Gleason sum upgrading. In summary, a new nomogram to predict Gleason sum upgrading in clinically diagnosed prostate cancer was developed, and it demonstrated good statistical performance upon internal validation.
authors.affiliation: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P. R. China. dwyeli@163.com.
authors.forename: Jin-You
authors.initials: JY
authors.lastname: Wang
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhu
authors.forename: Chao-Fu
authors.initials: CF
authors.lastname: Wang
authors.forename: Shi-Lin
authors.initials: SL
authors.lastname: Zhang
authors.forename: Bo
authors.initials: B
authors.lastname: Dai
authors.forename: Ding-Wei
authors.initials: DW
authors.lastname: Ye
mesh_terms: D000368:Aged; D001706:Biopsy; D015331:Cohort Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D049451:Nomograms; D017430:Prostate-Specific Antigen; D011468:Prostatectomy; D011471:Prostatic Neoplasms
chemical_list: D017430:Prostate-Specific Antigen