PD47-11 OPTIMUM TOOLS FOR PREDICTING CLINICAL OUTCOMES IN PROSTATE CANCER PATIENTS UNDERGOING RADICAL PROSTATECTOMY: A SYSTEMATIC REVIEW OF PROGNOSTIC ACCURACY AND VALIDITY

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History III1 Apr 2017PD47-11 OPTIMUM TOOLS FOR PREDICTING CLINICAL OUTCOMES IN PROSTATE CANCER PATIENTS UNDERGOING RADICAL PROSTATECTOMY: A SYSTEMATIC REVIEW OF PROGNOSTIC ACCURACY AND VALIDITY Jared Campbell, Elspeth Raymond, Michael O'Callaghan, Andrew Vincent, Kerri Beckmann, David Roder, Sue Evans, John McNeil, Jeremy Millar, John Zalcberg, Martin Borg, and Kim Moretti Jared CampbellJared Campbell More articles by this author , Elspeth RaymondElspeth Raymond More articles by this author , Michael O'CallaghanMichael O'Callaghan More articles by this author , Andrew VincentAndrew Vincent More articles by this author , Kerri BeckmannKerri Beckmann More articles by this author , David RoderDavid Roder More articles by this author , Sue EvansSue Evans More articles by this author , John McNeilJohn McNeil More articles by this author , Jeremy MillarJeremy Millar More articles by this author , John ZalcbergJohn Zalcberg More articles by this author , Martin BorgMartin Borg More articles by this author , and Kim MorettiKim Moretti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2371AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer progresses slowly, but its therapies often have adverse effects. Informed patient counselling regarding clinical outcomes is therefore important. The objective of this study was to identify all external validations of tools that predict clinical outcomes in prostate cancer patients undergoing radical prostatectomy, and evaluate which are optimum for clinical implementation. METHODS PubMed and Embase were systematically searched from 2007 to 2016. Search terms related to the inclusion criteria: prostate cancer, clinical outcomes, radical prostatectomy and prognosis. Titles/abstracts were screened and relevant studies were advanced to full-text review. The references of full-texts were reviewed for further studies. The Centre for Evidence-Based Medicine prognostic study tool was used for critical appraisal and the online tool Covidence was used for data extraction. RESULTS Seventy-three studies externally validated 41 post- and 13 pre-operative tools for the prediction of biochemical recurrence (BCR), aggressive BCR, metastasis, and prostate cancer specific mortality (PCSM). Recommendations for clinical implementation were made based on accuracy, cohort sizes, number of validations, and consistency. The accuracy of recommended tools ranged from 72-92% and 68-79% amongst the largest validation cohorts for post- and pre-operative tools, respectively. For post-operative prognosis we recommend the CAPRA-S, Stephenson, Kattan, DPC and the Suardi nomograms for the prediction of BCR, the DPC nomogram for aggressive BCR, the CAPRA-S and Eggener nomograms for metastasis, and the Eggener nomogram for PCSM. For pre-operative prognosis we recommend the CAPRA and Stephenson nomograms for BCR, the D′Amico criteria for aggressive BCR, the CAPRA nomogram for metastasis, and the D′Amico criteria for PCSM. CONCLUSIONS We identified all tools that can be used to predict clinical outcomes for prostate cancer patients undergoing radical prostatectomy. While many were inaccurate or not well validated, we recommend the best available tools to help clinicians give patients accurate predictions. Use of these tools should help clinicians deliver accurate, evidence based counselling to patients undergoing radical prostatectomy. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e900 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Jared Campbell More articles by this author Elspeth Raymond More articles by this author Michael O'Callaghan More articles by this author Andrew Vincent More articles by this author Kerri Beckmann More articles by this author David Roder More articles by this author Sue Evans More articles by this author John McNeil More articles by this author Jeremy Millar More articles by this author John Zalcberg More articles by this author Martin Borg More articles by this author Kim Moretti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...