Martini et al reported a nomogram for predicting extracapsular extension (ECE) of a prostate cancer. This can help identify a patient who may require more aggressive management. The authors are from Icahn School of Medicine at Mount Sinai and Vita-Salute San Raffaele University in Milan.
Patient selection: prostate cancer
Parameters:
(1) serum PSA in ng/mL
(2) Gleason grade (from 1 to 5)
(3) maximum percent of core positive with the highest Gleason score
(4) extracapsular extension on MRI scan
points for PSA =
= MIN(4.7,0.235 * (PSA))
Parameter
Finding
Points
Gleason grade
1
0
2
5.3
3
6.8
4 or 5
10
maximum percent
<= 50%
0
> 50%
1.5
ECE on MRI
no
0
yes
5.7
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 21.9
value of X =
= (0.2662 * (score)) - 3.882
probability of ECE =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve was 0.83.
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