title: Pre- and post-operative nomograms to predict recurrence-free probability in korean men with clinically localized prostate cancer.
abstract: OBJECTIVE
  Although the incidence of prostate cancer (PCa) is rapidly increasing in Korea, there are few suitable prediction models for disease recurrence after radical prostatectomy (RP). We established pre- and post-operative nomograms estimating biochemical recurrence (BCR)-free probability after RP in Korean men with clinically localized PCa.
  
  
  METHODS
  Our sampling frame included 3,034 consecutive men with clinically localized PCa who underwent RP at our tertiary centers from June 2004 through July 2011. After inappropriate data exclusion, we evaluated 2,867 patients for the development of nomograms. The Cox proportional hazards regression model was used to develop pre- and post-operative nomograms that predict BCR-free probability. Finally, we resampled from our study cohort 200 times to determine the accuracy of our nomograms on internal validation, which were designated with concordance index (c-index) and further represented by calibration plots.
  
  
  RESULTS
  Over a median of 47 months of follow-up, the estimated BCR-free rate was 87.8% (1 year), 83.8% (2 year), and 72.5% (5 year). In the pre-operative model, Prostate-Specific Antigen (PSA), the proportion of positive biopsy cores, clinical T3a and biopsy Gleason score (GS) were independent predictive factors for BCR, while all relevant predictive factors (PSA, extra-prostatic extension, seminal vesicle invasion, lymph node metastasis, surgical margin, and pathologic GS) were associated with BCR in the post-operative model. The c-index representing predictive accuracy was 0.792 (pre-) and 0.821 (post-operative), showing good fit in the calibration plots.
  
  
  CONCLUSIONS
  In summary, we developed pre- and post-operative nomograms predicting BCR-free probability after RP in a large Korean cohort with clinically localized PCa. These nomograms will be provided as the mobile application-based SNUH Prostate Cancer Calculator. Our nomograms can determine patients at high risk of disease recurrence after RP who will benefit from adjuvant therapy.
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Minyong
authors.initials: M
authors.lastname: Kang
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Jeong
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Woo Suk
authors.initials: WS
authors.lastname: Choi
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Park
authors.affiliation: Department of Urology, Seoul National University Boramae Hospital, Seoul, Republic of Korea.
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Sangchul
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Urology, Seoul National University Boramae Hospital, Seoul, Republic of Korea.
authors.forename: Seung Bae
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Ja Hyeon
authors.initials: JH
authors.lastname: Ku
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Hong
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
authors.affiliation: Department of Urology, Seoul National University Boramae Hospital, Seoul, Republic of Korea.
authors.forename: Hyeon
authors.initials: H
authors.lastname: Jeong
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Cheol
authors.initials: C
authors.lastname: Kwak
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Hyeon Hoe
authors.initials: HH
authors.lastname: Kim
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Eunsik
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D049451:Nomograms; D011184:Postoperative Period; D057234:Preoperative Period; D011336:Probability; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000601:surgery*; D056910:Republic of Korea
chemical_list: D017430:Prostate-Specific Antigen