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Purpose: Due to the availability of serum prostate specific antigen (PSA) testing, the detection rate of insignificant prostate cancer (IPC) is increasing. To ensure better treatment decisions, we developed a nomogram to predict the probability of IPC. Materials and Methods: The study population consisted of 1,471 patients who were treated at multiple institutions by radical prostatectomy without neoadjuvant therapy from 1995 to 2008. We obtained nonrandom samples of n=1,031 for nomogram development, leaving n=440 for nomogram validation. IPC was defined as pathologic organ-confined disease and a tumor volume of 0.5 cc or less without Gleason grade 4 or 5. Multivariate logistic regression model (MLRM) coefficients were used to construct a nomogram to predict IPC from five variables, including serum prostate specific antigen, clinical stage, biopsy Gleason score, positive cores ratio and maximum % of tumor in any core. The performance characteristics were internally validated from 200 bootstrap resamples to reduce overfit bias. External validation was also performed in another cohort. Results: Overall, 67 (6.5%) patients had a so-called "insignificant" tumor in nomogram development cohort. PSA, clinical stage, biopsy Gleason score, positive core ratio and maximum % of biopsy tumor represented significant predictors of the presence of IPC. The resulting nomogram had excellent discrimination accuracy, with a bootstrapped concordance index of 0.827. Conclusion: Our current nomogram provides sufficiently accurate information in clinical practice that may be useful to patients and clinicians when various treatment options for screen-detected prostate cancer are considered.

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참고문헌 (24건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 What is ‘insignificant’ prostate carcinoma? 네이버 미소장
2 Klotz L. Active surveillance for prostate cancer: for whom? J Clin Oncol 2005;23:8165-9. 미소장
3 Counseling Men With Prostate Cancer: A Nomogram for Predicting the Presence of Small, Moderately Differentiated, Confined Tumors 네이버 미소장
4 A nomogram for predicting low-volume/low-grade prostate cancer: a tool in selecting patients for active surveillance. 네이버 미소장
5 Critical assessment of tools to predict clinically insignificant prostate cancer at radical prostatectomy in contemporary men 네이버 미소장
6 Imaging low-risk prostate cancer. 네이버 미소장
7 Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. 네이버 미소장
8 NONPALPABLE STAGE T1C PROSTATE CANCER: PREDICTION OF INSIGNIFICANT DISEASE USING FREE/TOTAL PROSTATE SPECIFIC ANTIGEN LEVELS AND NEEDLE BIOPSY FINDINGS 네이버 미소장
9 Sakr WA, Grignon DJ, Crissman JD, Heilbrun LK, Cassin BJ, Pontes JJ, et al. High grade prostatic intraepithelial neoplasia (HGPIN) and prostatic adenocarcinoma between the ages of 20-69: an autopsy study of 249 cases. In Vivo 1994;8:439-43. 미소장
10 Latent carcinoma of the prostate. 네이버 미소장
11 Jemal A, Thomas A, Murray T, Thun M. Cancer Statistics, 2002. CA Cancer J Clin 2002;52:23-47. 미소장
12 AN ANALYSIS OF WATCHFUL WAITING FOR CLINICALLY LOCALIZED PROSTATE CANCER 네이버 미소장
13 Surgery and the reduction of mortality from prostate cancer. 네이버 미소장
14 Lead Times and Overdetection Due to Prostate-Specific Antigen Screening: Estimates From the European Randomized Study of Screening for Prostate Cancer 네이버 미소장
15 Prediction of Indolent Prostate Cancer: Validation and Updating of a Prognostic Nomogram 네이버 미소장
16 Serum Androgens and Sex Hormone-binding Globulins in Relation to Lifestyle Factors in Older African-American, White, and Asian Men in the United States and Canada 네이버 미소장
17 Ethnic differences in the age-related distribution of serum prostate-specific antigen values: a study in a healthy Korean male population 네이버 미소장
18 Differences in prognostic factors and survival among white and Asian men with prostate cancer, California, 1995–2004 네이버 미소장
19 Localized prostate cancer. Relationship of tumor volume to clinical significance for treatment of prostate cancer. 네이버 미소장
20 HISTOLOGICAL AND CLINICAL FINDINGS IN 896 CONSECUTIVE PROSTATES TREATED ONLY WITH RADICAL RETROPUBIC PROSTATECTOMY: EPIDEMIOLOGIC SIGNIFICANCE OF ANNUAL CHANGES 네이버 미소장
21 Soh S, Kattan MW, Berkman S, Wheeler TM, Scardino PT. Has there been a recent shift in the pathological features and prognosis of patients treated with radical prostatectomy? J Urol 1997;157: 2212-8. 미소장
22 RELATIONSHIP BETWEEN SYSTEMATIC BIOPSIES AND HISTOLOGICAL FEATURES OF 222 RADICAL PROSTATECTOMY SPECIMENS: LACK OF PREDICTION OF TUMOR SIGNIFICANCE FOR MEN WITH NONPALPABLE PROSTATE CANCER 네이버 미소장
23 Lee HW, Seo SI, Jeon SS, Lee HM, Choi HY. Can we predict real T3 stage prostate cancer in patients with clinical T3 (cT3) disease before radical prostatectomy? Yonsei Med J 2010;51:700-7. 미소장
24 Percentage Carcinoma as a Measure of Prostatic Tumor Size in Radical Prostatectomy Tissues 네이버 미소장

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