Kattan et al developed a preoperative nomogram for predicting the probability of a patient being recurrence free at 5 years following radical prostatectomy for prostate cancer. This can be an aid for planning patient management and providing informed consent. The nomogram was developed at Baylor College of Medicine and the Methodist Hospital in Houston.
Selection: man with prostate cancer with clinical stage T1a to T3a
Endpoint: recurrence free at 60 months (5 years) after radical prostatectomy
Parameters:
(1) serum PSA in ng/mL
(2) clinical stage
(3) Gleason score on the biopsy
The values were read from the nomogram (copyright Drs Kattan and Scardino). The data for PSA and probability were analyzed in JMP.
|
PSA |
Points |
|
0 to 3 |
(2.88425 * ((PSA)^3)) - (19.005 * ((PSA)^2)) + (43.92676 * (PSA)) - 4.2055 |
|
3 to 14 |
(-0.048317 * ((PSA)^3)) + (1.223099 * ((PSA)^2)) - (6.30505 * (PSA)) + 44.186 |
|
14 to 20 |
(2.095 * (PSA)) + 34.06 |
|
20 to 100 |
(-0.002373 * ((PSA)^2)) + (0.57358 * (PSA)) + 66.131 |
|
Clinical Stage |
Points |
|
T1a or T1b |
22.2 |
|
T1c |
0 |
|
T2a |
9.2 |
|
T2b |
30 |
|
T2c |
23.1 |
|
T3a |
47.6 |
|
Gleason Score on Preoperative Biopsy |
Points |
|
<= 2 + <= 2 |
0 |
|
<= 2 + 3 |
22.6 |
|
3 + <=2 |
25.7 |
|
3 + 3 |
25 |
|
<= 3 + >= 4 |
45.8 |
|
>= 4 + >=1 |
48.6 |
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum total score: 0
• maximum total score: 192 points
• The higher the score the less likely the patient will be recurrence free at 5 years.
|
Total Points |
Probability of Being Recurrence Free at 5 years |
|
0 - 38 |
> 96% |
|
38 - 121.1 |
(-0.000049 * ((points)^2)) + (0.0036289 * (points)) + 0.8896 |
|
121.1 - 180 |
(0.000042 * ((points)^2)) - (0.022457 * (points)) + 2.708667 |
|
180 - 200 |
< 5% |
where:
• The equations return a decimal fraction.
Specialty: Hematology Oncology, Surgery, general, Urology
