Martini et al reported a nomogram for predicting extracapsular extension of prostate cancer prior to radical prostatectomy. This can help to guide management and to inform the patient. The authors are from the Icahn School of Medicine at Mount Sinai in New York City and Vita-Salute San Raffaele University in Milan.
Patient selection: prostate cancer
Parameters:
(1) preoperative serum PSA in ng/mL
(2) highest Gleason biopsy grade from 1 to 5
(3) maximum percent of tumor in the biopsy core with the highest Gleason score
(4) extracapsular extension on MRI
points for PSA =
= MIN(4.7,0.235 * (PSA))
Parameter
Finding
Points
Gleason grade group
1
0
2
5.3
3
6.8
4 or 5
10
maximum percent of core
<=50%
0
> 50%
1.5
extracapsular extension on MRI
no
0
yes
5.7
total score =
= SUM(points for all 4 parameters)
value of X =
= (0.26715 * (score)) - 3.8898
probability of extracapsular extension =
= 1 / (1 + EXP((-1) * X))
Performance:
• The aera under the ROC curve is 0.82.
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