A pretreatment nomogram for prediction of biochemical failure after primary cryoablation of the prostate.

Journal Article (Journal Article)

BACKGROUND: To create a predictive nomogram for biochemical failure following primary whole-gland cryoablation of the prostate for localized prostate cancer (LPCa). METHODS: We retrospectively analyzed 2,242 patients from the Cryo On-Line Database (COLD) who were treatment naive and had undergone primary whole gland cryoablation of the prostate for biopsy-confirmed LPCa. Kaplan-Meier (KM) curves estimating 5 year biochemical progression-free survival (bPFS) were generated. Multivariable Cox proportional hazards analysis (CoxPH) was performed in order to construct the nomogram. The nomogram was internally validated using the bootstrap technique. RESULTS: Overall, the KM estimated 5 year bPFS was 72.8%. Stratified by D'Amico risk, The KM estimated 5 year bPFS was 82.6%, 71.1%, and 57.8% for low-, intermediate-, and high-risk groups, respectively. Statistically significant predictors of biochemical outcomes from CoxPH analysis were pre-treatment prostate specific antigen (PTPSA) (P < 0.001), total prostate volume (P = 0.004), clinical stage (P = 0.034), and Gleason score (0.004). A nomogram for predicted 5 year biochemical progression free probability was constructed with a concordance index of 0.652. An online risk calculator was also generated. CONCLUSIONS: To the best of our knowledge, this is the first predictive nomogram for biochemical outcomes after primary whole gland cryoablation of the prostate using socio-demographic, pretreatment, clinical, and prostate biopsy data. Our nomogram and online risk calculator can guide both patients and urologists for shared decision making regarding definitive treatment options.

Full Text

Duke Authors

Cited Authors

  • Elshafei, A; Kovac, E; Dhar, N; Levy, D; Polascik, T; Mouraviev, V; Yu, C; Jones, JS

Published Date

  • September 2015

Published In

Volume / Issue

  • 75 / 13

Start / End Page

  • 1447 - 1453

PubMed ID

  • 26172607

Electronic International Standard Serial Number (EISSN)

  • 1097-0045

Digital Object Identifier (DOI)

  • 10.1002/pros.23030


  • eng

Conference Location

  • United States