Volume 16, Issue 6 (November 2014) 16, 897–901; doi: 10.4103/1008-682X.129940
Risk prediction models for biochemical recurrence after radical prostatectomy using prostate-specific antigen and Gleason score
Xin-Hai Hu1, Henning Cammann2, Hellmuth-A Meyer1, Klaus Jung1,3, Hong-Biao Lu1,4, Natalia Leva5,
Ahmed Magheli1, Carsten Stephan1,3, Jonas Busch1
1Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany; 2Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Germany; 3Berlin Institute for Urologic Research, Berlin, Germany; 4Department of Urology, Changzhou No. 2 People’s Hospital, Changzhou, China; 5Stanford University School of Medicine, Stanford, CA, USA.
Correspondence: Dr. J Busch (jonas.busch@charite.de)
2014-7-4
Abstract |
Many computer models for predicting the risk of prostate cancer have been developed including for prediction of biochemical recurrence (BCR). However, models for individual BCR free probability at individual time-points after a BCR free period are rare. Follow-up data from 1656 patients who underwent laparoscopic radical prostatectomy (LRP) were used to develop an artificial neural network (ANN) to predict BCR and to compare it with a logistic regression (LR) model using clinical and pathologic parameters, prostate-specific antigen (PSA), margin status (R0/1), pathological stage (pT), and Gleason Score (GS). For individual BCR prediction at any given time after operation, additional ANN, and LR models were calculated every 6 months for up to 7.5 years of follow-up. The areas under the receiver operating characteristic (ROC) curve (AUC) for the ANN (0.754) and LR models (0.755) calculated immediately following LRP, were larger than that for GS (AUC: 0.715; P = 0.0015 and 0.001), pT or PSA (AUC: 0.619; P always <0.0001) alone. The GS predicted the BCR better than PSA ( 0.0001), but there was no difference between the ANN and LR models ( 0.39). Our ANN and LR models predicted individual BCR risk from radical prostatectomy for up to 10 years postoperative. ANN and LR models equally and significantly improved the prediction of BCR compared with PSA and GS alone. When the GS and ANN output values are combined, a more accurate BCR prediction is possible, especially in high-risk patients with GS ≥7.
Keywords: artificial neural network; prostate cancer; recurrence
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