A study of pretreatment nomograms to predict pathological stage and biochemical recurrence after radical prostatectomy for clinically resectable prostate cancer in Japanese men

Background: Accurate pretreatment identification of the risks that prostate cancer has extended beyond the gland and that it will recur would signific antly influence practice patterns. Preoperative nomograms to predict such r isks have not been developed for the oriental male population. Methods: Construction of nomograms to predict preoperatively pathological o utcome and early biochemical failure following radical prostatectomy in Jap anese males was based on logistic regression analysis, with predicted proba bilities and 95% confidence intervals for the final model being obtained by repeating the analysis on 1000 bootstrap samples from the original cohort. Results: Prostate-specific antigen level, clinical stage and biopsy Gleason score contributed significantly to the prediction of pathological stage an d of biochemical failure in the univariate analysis (p < 0.001). Combined u se of these three variables predicted these treatment outcomes better than any single variable (p < 0.001). Nomograms combining these three variables to predict final pathological findings and early biochemical failure were t hen developed. The medians and 95% confidence intervals of the predicted pr obabilities are presented in the nomograms. Conclusions: This information enables clinicians to use their nomograms whe n counseling Japanese patients, leading to more informed treatment decision s and helping to identify those with a high risk of early biochemical failu re. The nomograms may also be used to assure comparability of different tre atment modalities in investigational trials.