Nomograms to predict pathologic results of radical prostatectomy: Effect of neoadjuvant hormone therapy

The published nomograms for prediction of pathologic stage at radical prost atecomy are not applicable to patients treated with neoadjuvant hormone the rapy (NHT), This retrospective study was performed to develop and validate nomograms for the prediction of pathologic results with radical prostatecto my with or without NHT for use in clinical decision making and patient coun seling. There were 1282 consecutive patients with clinical stage T-1a-T-2c prostate cancer undergoing radical prostatectomy with or without NHT betwee n February 1985 and August 1997 for whom all preoperative variables were kn own. Sixty percent of the patients were randomly chosen to generate the nom ograms, and the remaining 40% were used for validation, Pretreatment PSA, b iopsy grade, clinical stage, and lack of NHT were statistically significant predictors of extracapsular extension. Pretreatment PSA, biopsy grade, and lack of NHT were statistically significant predictors of seminal vesicle i nvasion. Only pretreatment PSA was a predictor of nodal metastases, The are as under the receiver-operator characteristic curves for the nomograms were 0.70, 0.80, and 0.78 for the prediction of extracapsular extension, semina l vesicle invasion, and nodal metastases, respectively, The nomograms were validated in a randomly selected independent group of patients. These nomog rams aid in clinical decision making and patient counseling regarding the b enefit of NHT and radical prostatectomy.