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Prostate Cancer Nomograms: A Review of Their Use in Cancer Detection and Treatment

  • Prostate Cancer (D Parekh, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

As prostate cancer treatment discussions have grown more complex, increasing numbers of nomograms to guide decision-making have been found in the literature. Such nomograms can influence every step in the prostate cancer therapeutic process, from determining the need for biopsy to the need for adjuvant therapy. With a properly counseled patient who is aware of the limitations of nomograms, such tools assist in the shared decision-making that characterizes modern informed consent.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Shariat SF, Karakiewicz PI, Roehrborn CG, Kattan MW. An updated catalog of prostate cancer predictive tools. Cancer. 2008;113(11):3075–99.

    Article  PubMed  Google Scholar 

  2. Moyer VA, U.S. Preventive Services Task Force. Screening for prostate cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 2012;157(2):120–34.

    Article  PubMed  Google Scholar 

  3. Heidenreich A, Bellmunt J, Bolla M, et al. EAU guidelines on prostate cancer. part 1: Screening, diagnosis, and treatment of clinically localised disease. Eur Urol. 2011;59(1):61–71.

    Article  PubMed  Google Scholar 

  4. Carter HB, Albertsen PC, Barry MJ, et al. Early detection of prostate cancer: AUA guideline. J Urol. 2013;190(2):419–26.

    Article  PubMed  Google Scholar 

  5. Kranse R, Roobol M, Schroder FH. A graphical device to represent the outcomes of a logistic regression analysis. Prostate. 2008;68(15):1674–80.

    Article  PubMed  Google Scholar 

  6. Thompson IM, Ankerst DP, Chi C, et al. Assessing prostate cancer risk: Results from the prostate cancer prevention trial. J Natl Cancer Inst. 2006;98(8):529–34.

    Article  PubMed  Google Scholar 

  7. Karakiewicz PI, Benayoun S, Kattan MW, et al. Development and validation of a nomogram predicting the outcome of prostate biopsy based on patient age, digital rectal examination and serum prostate specific antigen. J Urol. 2005;173(6):1930–4.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Oliveira M, Marques V, Carvalho AP, Santos A. Head-to-head comparison of two online nomograms for prostate biopsy outcome prediction. BJU Int. 2011;107(11):1780–3.

    Article  PubMed  Google Scholar 

  9. Ouzaid I, Yates DR, Hupertan V, et al. A direct comparison of the diagnostic accuracy of three prostate cancer nomograms designed to predict the likelihood of a positive initial transrectal biopsy. Prostate. 2012;72(11):1200–6.

    Article  PubMed  Google Scholar 

  10. Tang P, Chen H, Uhlman M, et al. A nomogram based on age, prostate-specific antigen level, prostate volume and digital rectal examination for predicting risk of prostate cancer. Asian J Androl. 2013;15(1):129–33.

    Article  CAS  PubMed  Google Scholar 

  11. Salagierski M, Mulders P, Schalken JA. Predicting prostate biopsy outcome using a PCA3-based nomogram in a polish cohort. Anticancer Res. 2013;33(2):553–7.

    PubMed  Google Scholar 

  12. Nomura M, Ito K, Miyakubo M, et al. Development and external validation of a nomogram for predicting cancer probability at initial prostate biopsy using the life expectancy- and prostate volume-adjusted biopsy scheme. Prostate Cancer Prostatic Dis. 2012;15(2):202–9.

    Article  CAS  PubMed  Google Scholar 

  13. Chun FK, de la Taille A, van Poppel H, et al. Prostate cancer gene 3 (PCA3): Development and internal validation of a novel biopsy nomogram. Eur Urol. 2009;56(4):659–67.

    Article  PubMed  Google Scholar 

  14. Lughezzani G, Lazzeri M, Larcher A, et al. Development and internal validation of a prostate health index based nomogram for predicting prostate cancer at extended biopsy. J Urol. 2012;188(4):1144–50.

    Article  PubMed  Google Scholar 

  15. Steyerberg EW, Vickers AJ. Decision curve analysis: A discussion. Med Decis Making. 2008;28(1):146–9.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Nam RK, Kattan MW, Chin JL, et al. Prospective multi-institutional study evaluating the performance of prostate cancer risk calculators. J Clin Oncol. 2011;29(22):2959–64. This article is of particular importance to the field as it applies a method of decision curve analysis that can be used to evaluate not just the accuracy, and calibration of nomograms, but demonstrated how this type of analysis can be used to evaluate a nomograms clinical performance, tying prediction to patient benefit. Its methods will serve as a benchmark for further validating future nomogram performance.

    Article  PubMed  Google Scholar 

  17. Eifler JB, Feng Z, Lin BM, et al. An updated prostate cancer staging nomogram (partin tables) based on cases from 2006 to 2011. BJU Int. 2013;111(1):22–9. The authors have updated the time-tested Partin tables using a modern cohort of 5,629 men at Johns Hopkins Hospital. The update improves the applicability of the earlier Partin tables by selecting a group of men diagnosed after the 2005 Gleason scoring update had been established.

    Article  PubMed  Google Scholar 

  18. Kattan MW, Eastham JA, Wheeler TM, et al. Counseling men with prostate cancer: A nomogram for predicting the presence of small, moderately differentiated, confined tumors. J Urol. 2003;170(5):1792–7.

    Article  PubMed  Google Scholar 

  19. Roemeling S, Roobol MJ, Kattan MW, van der Kwast TH, Steyerberg EW, Schroder FH. Nomogram use for the prediction of indolent prostate cancer: Impact on screen-detected populations. Cancer. 2007;110(10):2218–21.

    Article  PubMed  Google Scholar 

  20. Nakanishi H, Wang X, Ochiai A, et al. A nomogram for predicting low-volume/low-grade prostate cancer: A tool in selecting patients for active surveillance. Cancer. 2007;110(11):2441–7.

    Article  PubMed  Google Scholar 

  21. Steyerberg EW, Roobol MJ, Kattan MW, van der Kwast TH, de Koning HJ, Schroder FH. Prediction of indolent prostate cancer: Validation and updating of a prognostic nomogram. J Urol. 2007;177(1):107–12. discussion 112.

    Article  CAS  PubMed  Google Scholar 

  22. Chun FK, Briganti A, Shariat SF, et al. Significant upgrading affects a third of men diagnosed with prostate cancer: Predictive nomogram and internal validation. BJU Int. 2006;98(2):329–34.

    Article  PubMed  Google Scholar 

  23. Moussa AS, Kattan MW, Berglund R, Yu C, Fareed K, Jones JS. A nomogram for predicting upgrading in patients with low- and intermediate-grade prostate cancer in the era of extended prostate sampling. BJU Int. 2010;105(3):352–8.

    Article  PubMed  Google Scholar 

  24. Roscigno M, Scattoni V, Freschi M, et al. Diagnosis of isolated high-grade prostatic intra-epithelial neoplasia: Proposal of a nomogram for the prediction of cancer detection at saturation re-biopsy. BJU Int. 2012;109(9):1329–34.

    Article  PubMed  Google Scholar 

  25. Iremashvili V, Soloway MS, Pelaez L, Rosenberg DL, Manoharan M. Comparative validation of nomograms predicting clinically insignificant prostate cancer. Urology. 2013;81(6):1202–8.

    Article  PubMed  Google Scholar 

  26. O'Brien BA, Cohen RJ, Ryan A, Sengupta S, Mills J. A new preoperative nomogram to predict minimal prostate cancer: Accuracy and error rates compared to other tools to select patients for active surveillance. J Urol. 2011;186(5):1811–7.

    Article  PubMed  Google Scholar 

  27. Shukla-Dave A, Hricak H, Akin O, et al. Preoperative nomograms incorporating magnetic resonance imaging and spectroscopy for prediction of insignificant prostate cancer. BJU Int. 2012;109(9):1315–22.

    Article  PubMed Central  PubMed  Google Scholar 

  28. NCCN clinical practice guidelines in oncology (NCCN guideline) prostate cancer. http://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Updated 2013. Accessed 08/2013

  29. Abdollah F, Schmitges J, Sun M, et al. A population-based assessment of the national comprehensive cancer network practice guideline indications for pelvic lymph node dissection at radical prostatectomy. BJU Int. 2012;109(8):1177–82.

    Article  PubMed  Google Scholar 

  30. Schmitges J, Karakiewicz PI, Sun M, et al. Predicting the risk of lymph node invasion during radical prostatectomy using the european association of urology guideline nomogram: A validation study. Eur J Surg Oncol. 2012;38(7):624–9.

    Article  CAS  PubMed  Google Scholar 

  31. Briganti A, Karakiewicz PI, Chun FK, et al. Percentage of positive biopsy cores can improve the ability to predict lymph node invasion in patients undergoing radical prostatectomy and extended pelvic lymph node dissection. Eur Urol. 2007;51(6):1573–81.

    Article  PubMed  Google Scholar 

  32. Briganti A, Larcher A, Abdollah F, et al. Updated nomogram predicting lymph node invasion in patients with prostate cancer undergoing extended pelvic lymph node dissection: The essential importance of percentage of positive cores. Eur Urol. 2012;61(3):480–7.

    Article  PubMed  Google Scholar 

  33. Walz J, Bladou F, Rousseau B, et al. Head to head comparison of nomograms predicting probability of lymph node invasion of prostate cancer in patients undergoing extended pelvic lymph node dissection. Urology. 2012;79(3):546–51.

    Article  PubMed  Google Scholar 

  34. Ohori M, Kattan MW, Koh H, et al. Predicting the presence and side of extracapsular extension: A nomogram for staging prostate cancer. J Urol. 2004;171(5):1844–9. discussion 1849.

    Article  PubMed  Google Scholar 

  35. Steuber T, Graefen M, Haese A, et al. Validation of a nomogram for prediction of side specific extracapsular extension at radical prostatectomy. J Urol. 2006;175(3 Pt 1):939–44. discussion 944.

    Article  PubMed  Google Scholar 

  36. Chung JS, Choi HY, Song HR, et al. Preoperative nomograms for predicting extracapsular extension in korean men with localized prostate cancer: A multi-institutional clinicopathologic study. J Korean Med Sci. 2010;25(10):1443–8.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Stephenson AJ, Scardino PT, Eastham JA, et al. Preoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Natl Cancer Inst. 2006;98(10):715–7.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Kattan MW, Eastham JA, Stapleton AM, Wheeler TM, Scardino PT. A preoperative nomogram for disease recurrence following radical prostatectomy for prostate cancer. J Natl Cancer Inst. 1998;90(10):766–71.

    Article  CAS  PubMed  Google Scholar 

  39. Eskicorapci SY, Turkeri L, Karabulut E, et al. Validation of two preoperative kattan nomograms predicting recurrence after radical prostatectomy for localized prostate cancer in turkey: A multicenter study of the uro-oncology society. Urology. 2009;74(6):1289–95.

    Article  PubMed  Google Scholar 

  40. Yeung VH, Chiu Y, Yu SS, Au WH, Chan SW. Are preoperative kattan and stephenson nomograms predicting biochemical recurrence after radical prostatectomy applicable in the chinese population? Sci World J. 2013;2013:506062.

    Article  Google Scholar 

  41. Punnen S, Freedland SJ, Presti JC, Jr, et al. Multi-institutional validation of the CAPRA-S score to predict disease recurrence and mortality after radical prostatectomy. Eur Urol. 2013.

  42. Suardi N, Porter CR, Reuther AM, et al. A nomogram predicting long-term biochemical recurrence after radical prostatectomy. Cancer. 2008;112(6):1254–63.

    Article  PubMed  Google Scholar 

  43. Walz J, Chun FK, Klein EA, et al. Nomogram predicting the probability of early recurrence after radical prostatectomy for prostate cancer. J Urol. 2009;181(2):601–7. discussion 607-8.

    Article  PubMed  Google Scholar 

  44. Stoyanova R, Pahlajani NH, Egleston BL, et al. The impact of dose-escalated radiotherapy plus androgen deprivation for prostate cancer using 2 linked nomograms. Cancer. 2013;119(5):1080–8. The authors used linked nomograms to better describe net benefit to men with advanced disease by combining androgen deprivation as well as standard and escalated dose radiotherapy. This allows for nuanced treatment discussion with a high risk patient population and better allows selection of individual or combined therapies to achieve improved biochemical control.

    Article  CAS  PubMed  Google Scholar 

  45. Freedland S, Mithal P. Editorial comment. Urology. 2013;81(6):1208.

    Article  PubMed  Google Scholar 

  46. Bian XJ, Zhu Y, Shen YJ, et al. The effectiveness of the TAX 327 nomogram in predicting overall survival in chinese patients with metastatic castration-resistant prostate cancer. Asian J Androl. 2013.

  47. Fu AZ, Cantor SB, Kattan MW. Use of nomograms for personalized decision-analytic recommendations. Med Decis Making. 2010;30(2):267–74.

    Article  PubMed  Google Scholar 

  48. Shariat SF, Karakiewicz PI, Suardi N, Kattan MW. Comparison of nomograms with other methods for predicting outcomes in prostate cancer: A critical analysis of the literature. Clin Cancer Res. 2008;14(14):4400–7.

    Article  CAS  PubMed  Google Scholar 

  49. Vickers AJ. Prediction models: Revolutionary in principle, but do they do more good than harm? J Clin Oncol. 2011;29(22):2951–2.

    Article  PubMed  Google Scholar 

  50. Roupret M, Hupertan V, Comperat E, et al. Cross-cultural validation of a prognostic tool: Example of the kattan preoperative nomogram as a predictor of prostate cancer recurrence after radical prostatectomy. BJU Int. 2009;104(6):813–7. discussion 817-8.

    Article  CAS  PubMed  Google Scholar 

  51. Hinev AI, Anakievski D, Kolev N, Marianovski V, Hadjiev V. Validation of pre- and postoperative nomograms used to predict the pathological stage and prostate cancer recurrence after radical prostatectomy: A multi-institutional study. J BUON. 2011;16(2):316–22.

    CAS  PubMed  Google Scholar 

  52. Gacci M, Schiavina R, Lanciotti M, et al. External validation of the updated nomogram predicting lymph node invasion in patients with prostate cancer undergoing extended pelvic lymph node dissection. Urol Int. 2013;90(3):277–82.

    Article  PubMed  Google Scholar 

  53. Nguyen CT, Kattan MW. Development of a prostate cancer metagram: A solution to the dilemma of which prediction tool to use in patient counseling. Cancer. 2009;115(13 Suppl):3039–45.

    Article  PubMed  Google Scholar 

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Conflict of Interest

Dr. Ronald J. Caras and Dr. Joseph R. Sterbis each declare no potential conflict of interest relevant to this article.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96859, USA

    R. J. Caras & Joseph R. Sterbis

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  1. R. J. Caras
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  2. Joseph R. Sterbis
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Correspondence to Joseph R. Sterbis.

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This article is part of the Topical Collection on Prostate Cancer

The views expressed are those of the author(s) and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.

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Caras, R.J., Sterbis, J.R. Prostate Cancer Nomograms: A Review of Their Use in Cancer Detection and Treatment. Curr Urol Rep 15, 391 (2014). https://doi.org/10.1007/s11934-013-0391-0

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