EAU 2017: A nomogram for prediction of local cancer recurrence after primary prostate cryoablation

London, England (UroToday.com) Nomograms are clinically relevant tools able to be used by the clinician to help counsel patients and predict outcomes. In the setting of focal therapy for localized prostate cancer, nomograms can serve an important role in helping to identify risk of recurrence or progression. As the technology develops and the follow-up data becomes more robust, we will likely need new nomograms along the way.

In this abstract, the authors focus on primary prostate whole-gland cryoablation. They develop a nomogram to predict local cancer recurrence after therapy. They utilized the data from 961 patients from the Cryo On-Line Data (COLD) registry who underwent primary full gland cryoablation for prostate cancer and subsequently received post-treatment prostate biopsy. Pre- and post-treatment variables of interest (PSA, PGG, ≥cT3 ,NADT, PSA nadir, BCR (Phoenix criteria), TUPSA, time on undetectable PSA and various interaction terms) were identified and used to predict time to positive biopsy. These were then used to construct two separate nomograms.

Unfortunately, very little data regarding patient demographics was presented. Of note, post-treatment biopsy was positive in 28.2% (though timing is unknown). The median pre-treatment PSA was 6.8 ng/ml. Biopsy prognostic grade group (PGG) ranged from 1 to 5 in 70%, 12%, 6%, 8% and 3% of men respectively. 14% had a clinical stage ≥cT3.

Pre-treatment nomogram:

chart 13

The variables with the most effect: Biopsy gleason grade, cT3 disease, lack of neoadjuvant ADT, PSA. C-index: 61%

Post-treatment nomogram:

chart 13b

The variables with the most effect: PSA nadir, time on undetectable PSA, nADT with nadir > 0.2. C-index 71%.

Speaker: S. Luzzago

Co-Author(s): El Shafei A., Tay K.J., Ross A., Given R., Parsons J.K, Mouraviev V., Polascik T., Jones J.S.

Institution(s):
1. Cleveland Clinic Foundation, Glickman Urological and Kidney Institute, Cleveland, United States of America
2. Duke Cancer Institute, Dept. of Urology, Durham, United States of America
3. The Johns Hopkins Medical Institution, Dept. of Urology, Baltimore, United States of America
4. Eastern Virginia Medical School, Dept. of Urology, Virginia, United States of America
5. UC San Diego Health System, Dept. of Urology, San Diego, United States of America
6. Global Robotics Institute, Dept. of Urology, Celebration, United States of America

Written By: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto
Twitter: @tchandra_uromd

at the #EAU17 - March 24-28, 2017- London, England
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