Medical & Surgical Urology
Open Access

Abstract

Nomogram for Overall Survival of Japanese Patients with Bone Metastatic Prostate Cancer

Yasuhide Miyoshi, Kazumi Noguchi, Masahiro Yanagisawa, Masataka Taguri, Satoshi Morita, Ichiro Ikeda, Kiyoshi Fujinami, Takeshi Miura, Kazuki Kobayashi, Yoshinobu Kubota and Hiroji Uemura

Objective: We analyzed the relationship between prostate cancer outcome and pretreatment clinical factors, and developed a prognostic nomogram for Overall Survival (OS) of patients with bone metastasis.

Methods: Beginning in 1993 to 2011, 463 consecutive prostate cancer patients with bone metastasis were treated. Data sets from 361 patients were used to develop the nomogram (training data), and data sets of 102 patients were used for validation of the nomogram (validation data). Using the external validation data set, the nomogram was assessed for discriminatory ability, and the predictions were assessed for calibration accuracy by plotting actual survival against predicted risk.

Results: Of 361 training data set, 205 (56.8%) patients died, 169 (46.8%) deaths of which were due to prostate cancer. The Median follow-up of patients were 55.2 months. In multivariate analysis, patient age, serum PSA, clinical T stage, extent of disease on bone scan (EOD), and biopsy Gleason sum were independent prognostic factors. We developed a prognostic model for prostate cancer patients with bone metastasis, consisting of these five factors. This nomogram can be used to estimate 1-, 3-, and 5-year survival probability. External validation of this model using 102 validation data sets showed reasonable accuracy (c-index 0.719), although with slight underestimation.

Conclusion: Our pretreatment prognostic nomogram might be useful for Japanese prostate cancer patients with bone metastasis