title: Development and comparison of a Chinese nomogram adding multi-parametric MRI information for predicting extracapsular extension of prostate cancer.
abstract: OBJECTIVE
  To improve the performation of a nomogram for predicting side-specific extracapsular extension (SS-ECE).
  
  
  RESULTS
  One hundred and ninety-six patients (55.5%) had ECE on final pathology. Bilateral and unilateral ECE rate was 13.9% (49/353) and 41.6% (147/353), respectively. The mean age was 65.9 years and the mean serum prostate specific antigen (PSA) was 15.0 ng/ml. Based on multivariate logistic regression analysis, clinical stage (cStage), PSA, Gleason sum, percentage of positive cores, and ECE risk score were significant predictors of ECE. The current nomogram had higher predictive accuracy (0.851) and superior calibration. According to the decision curve analysis (DCA) results, the updated nomogram demonstrated a high net benefit across a wide range of threshold probabilities.
  
  
  METHODS
  We studied 353 patients with cStage T1c-T3 prostate cancer underwent radical prostatectomy. The candidate predictors associated with ECE were cStage, PSA, Gleason sum, percentage of positive cores, maximum cancer percentage and ECE risk score from multi-parametric magnetic resonance imaging (MP-MRI). The receiver operating characteristic (ROC) analysis was performed and an updated nomogram was constructed. The DCA was performed to test the predictive ability of the nomogram. In addition, the validation and calibration of the Memorial Sloan-Kettering cancer center (MSKCC) nomograms were performed in the current subjects.
  
  
  CONCLUSIONS
  Predictors, including cStage, PSA, Gleason sum, percentage of positive cores, maximum cancer percentage, and ECE risk score, were combined to construct a SS-ECE prediction nomogram. And the current nomogram might help urologists in decision-making process of preserving or resecting neurovascular bundles preoperatively.
authors: Department of Urology, Peking University First Hospital, Xicheng, Beijing, China.|Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
authors: Yuke
authors: Y
authors: Chen
authors: Department of Urology, Peking University First Hospital, Xicheng, Beijing, China.|Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
authors: Wei
authors: W
authors: Yu
authors: Department of Urology, Peking University First Hospital, Xicheng, Beijing, China.|Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
authors: Yu
authors: Y
authors: Fan
authors: Department of Urology, Peking University First Hospital, Xicheng, Beijing, China.|Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
authors: Liqun
authors: L
authors: Zhou
authors: Department of Urology, Peking University First Hospital, Xicheng, Beijing, China.
authors: Yang
authors: Y
authors: Yang
authors: Department of Radiology, Peking University First Hospital, Xicheng, Beijing, China.
authors: Huihui
authors: H
authors: Wang
authors: Department of Radiology, Peking University First Hospital, Xicheng, Beijing, China.
authors: Yuan
authors: Y
authors: Jiang
authors: Department of Radiology, Peking University First Hospital, Xicheng, Beijing, China.
authors: Xiaoying
authors: X
authors: Wang
authors: Department of Urology, Peking University First Hospital, Xicheng, Beijing, China.|Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
authors: Shiliang
authors: S
authors: Wu
authors: Department of Urology, Peking University First Hospital, Xicheng, Beijing, China.|Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
authors: Jie
authors: J
authors: Jin
mesh_terms: D000368:Aged; D003661:Decision Support Techniques; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D049451:Nomograms; D011237:Predictive Value of Tests; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012372:ROC Curve
keywords: extracapsular extension; multi-parametric magnetic resonance imaging; nomogram; prostate cancer; radical prostatectomy