Validation of user-friendly models predicting extracapsular extension in prostate cancer patients

Objective: There are many models to predict extracapsular extension (ECE) in patients with prostate cancer. We aimed to externally validate several models in a Japanese cohort. Methods: We included patients treated with robotic-assisted radical prostatectomy for prostate cancer. The risk of ECE was...

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Main Authors: Leandro Blas, Masaki Shiota, Shohei Nagakawa, Shigehiro Tsukahara, Takashi Matsumoto, Ken Lee, Keisuke Monji, Eiji Kashiwagi, Junichi Inokuchi, Masatoshi Eto
Format: Article
Language:English
Published: Elsevier 2023-01-01
Series:Asian Journal of Urology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214388222000273
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author Leandro Blas
Masaki Shiota
Shohei Nagakawa
Shigehiro Tsukahara
Takashi Matsumoto
Ken Lee
Keisuke Monji
Eiji Kashiwagi
Junichi Inokuchi
Masatoshi Eto
author_facet Leandro Blas
Masaki Shiota
Shohei Nagakawa
Shigehiro Tsukahara
Takashi Matsumoto
Ken Lee
Keisuke Monji
Eiji Kashiwagi
Junichi Inokuchi
Masatoshi Eto
author_sort Leandro Blas
collection DOAJ
description Objective: There are many models to predict extracapsular extension (ECE) in patients with prostate cancer. We aimed to externally validate several models in a Japanese cohort. Methods: We included patients treated with robotic-assisted radical prostatectomy for prostate cancer. The risk of ECE was calculated for each patient in several models (prostate side-specific and non-side-specific). Model performance was assessed by calculating the receiver operating curve and the area under the curve (AUC), calibration plots, and decision curve analyses. Results: We identified ECE in 117 (32.9%) of the 356 prostate lobes included. Patients with ECE had a statistically significant higher prostate-specific antigen level, percentage of positive digital rectal examination, percentage of hypoechoic nodes, percentage of magnetic resonance imaging nodes or ECE suggestion, percentage of biopsy positive cores, International Society of Urological Pathology grade group, and percentage of core involvement. Among the side-specific models, the Soeterik, Patel, Sayyid, Martini, and Steuber models presented AUC of 0.81, 0.78, 0.77, 0.75, and 0.73, respectively. Among the non-side-specific models, the memorial Sloan Kettering Cancer Center web calculator, the Roach formula, the Partin tables of 2016, 2013, and 2007 presented AUC of 0.74, 0.72, 0.64, 0.61, and 0.60, respectively. However, the 95% confidence interval for most of these models overlapped. The side-specific models presented adequate calibration. In the decision curve analyses, most models showed net benefit, but it overlapped among them. Conclusion: Models predicting ECE were externally validated in Japanese men. The side-specific models predicted better than the non-side-specific models. The Soeterik and Patel models were the most accurate performing models.
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spelling doaj-art-413df8fe86c246838d5aa77174dc03912025-08-20T01:55:38ZengElsevierAsian Journal of Urology2214-38822023-01-01101818810.1016/j.ajur.2022.02.008Validation of user-friendly models predicting extracapsular extension in prostate cancer patientsLeandro Blas0Masaki Shiota1Shohei Nagakawa2Shigehiro Tsukahara3Takashi Matsumoto4Ken Lee5Keisuke Monji6Eiji Kashiwagi7Junichi Inokuchi8Masatoshi Eto9Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanCorresponding author.; Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanDepartment of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanObjective: There are many models to predict extracapsular extension (ECE) in patients with prostate cancer. We aimed to externally validate several models in a Japanese cohort. Methods: We included patients treated with robotic-assisted radical prostatectomy for prostate cancer. The risk of ECE was calculated for each patient in several models (prostate side-specific and non-side-specific). Model performance was assessed by calculating the receiver operating curve and the area under the curve (AUC), calibration plots, and decision curve analyses. Results: We identified ECE in 117 (32.9%) of the 356 prostate lobes included. Patients with ECE had a statistically significant higher prostate-specific antigen level, percentage of positive digital rectal examination, percentage of hypoechoic nodes, percentage of magnetic resonance imaging nodes or ECE suggestion, percentage of biopsy positive cores, International Society of Urological Pathology grade group, and percentage of core involvement. Among the side-specific models, the Soeterik, Patel, Sayyid, Martini, and Steuber models presented AUC of 0.81, 0.78, 0.77, 0.75, and 0.73, respectively. Among the non-side-specific models, the memorial Sloan Kettering Cancer Center web calculator, the Roach formula, the Partin tables of 2016, 2013, and 2007 presented AUC of 0.74, 0.72, 0.64, 0.61, and 0.60, respectively. However, the 95% confidence interval for most of these models overlapped. The side-specific models presented adequate calibration. In the decision curve analyses, most models showed net benefit, but it overlapped among them. Conclusion: Models predicting ECE were externally validated in Japanese men. The side-specific models predicted better than the non-side-specific models. The Soeterik and Patel models were the most accurate performing models.http://www.sciencedirect.com/science/article/pii/S2214388222000273PrognosisProstate cancerNomogramExtracapsular extension
spellingShingle Leandro Blas
Masaki Shiota
Shohei Nagakawa
Shigehiro Tsukahara
Takashi Matsumoto
Ken Lee
Keisuke Monji
Eiji Kashiwagi
Junichi Inokuchi
Masatoshi Eto
Validation of user-friendly models predicting extracapsular extension in prostate cancer patients
Asian Journal of Urology
Prognosis
Prostate cancer
Nomogram
Extracapsular extension
title Validation of user-friendly models predicting extracapsular extension in prostate cancer patients
title_full Validation of user-friendly models predicting extracapsular extension in prostate cancer patients
title_fullStr Validation of user-friendly models predicting extracapsular extension in prostate cancer patients
title_full_unstemmed Validation of user-friendly models predicting extracapsular extension in prostate cancer patients
title_short Validation of user-friendly models predicting extracapsular extension in prostate cancer patients
title_sort validation of user friendly models predicting extracapsular extension in prostate cancer patients
topic Prognosis
Prostate cancer
Nomogram
Extracapsular extension
url http://www.sciencedirect.com/science/article/pii/S2214388222000273
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