Traditional Prostate Cancer Risk Assessment Scales Do Not Predict Outcomes from Brain Metastases: A Population-Based Predictive Nomogram
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Cohort Selection
2.3. Statistical Analyses
3. Results
3.1. Descriptive Data
3.2. Univariate Analysis
3.3. Multivariable Analysis
3.4. Nomogram and Validation
4. Discussion
4.1. Traditional Prostate Cancer Risk Predictors
4.2. Race and Ethnicity
4.3. Tumor Size
4.4. Concurrent Metastases
4.5. Treatment
4.6. Predictive Modeling
4.7. Limitations and Generalizability
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Category | Subcategory | Patients | Percentage | Survival (Months) | [95% CI] | Univariate | |||
---|---|---|---|---|---|---|---|---|---|
HR | [95% CI] | p | Sig | ||||||
Overall | 461 | 100.00 | 13 | [11–15] | |||||
Age | 0–64 | 156 | 33.84 | 14 | [11–18] | reference | |||
65+ | 305 | 66.16 | 11 | [9–14] | 1.167 | [0.9346–1.457] | 0.173 | ||
Race | Non-Hispanic White | 295 | 63.99 | 10 | [8–14] | reference | |||
Hispanic (all races) | 63 | 13.67 | 17 | [12–39] | 0.6008 | [0.4203–0.8588] | 0.005 | ** | |
American Indian/Alaska Native | 3 | 0.65 | 16 | [0.5–NA] | 0.6942 | [0.1724–2.7952] | 0.608 | ||
Asian or Pacific Islander | 24 | 5.21 | 10 | [6–16] | 1.2317 | [0.7874–1.9269] | 0.361 | ||
Black | 76 | 16.49 | 16 | [13–19] | 0.8441 | [0.6327–1.1260] | 0.249 | ||
Tumor Size (cm) | <3 | 8 | 3.19 | NA | [NA–NA] | reference | |||
>3 | 16 | 6.37 | 19 | [2–NA] | 11.699 | [1.478–92.58] | 0.020 | * | |
PSA value (ng/mL) | <97.9 ng/mL | 104 | 42.80 | 11 | [7–16] | reference | |||
>97.9 ng/mL | 139 | 57.20 | 14 | [11–19] | 0.9219 | [0.7005–1.213] | 0.561 | ||
ISUP Grading (TURP) | Grade 1–4 | 44 | 44.90 | 17.5 | [10–19] | reference | |||
Grade 5 | 54 | 55.10 | 13.0 | [10–38] | 1.118 | [0.720–1.735] | 0.619 | ||
Additional Metastases | None | 66 | 14.32 | 18 | [13–39] | reference | |||
Bone | 261 | 56.62 | 12 | [10–16] | 1.40859 | [1.0119–1.961] | 0.042 | * | |
Bone and Liver | 14 | 3.04 | 8 | [4–NA] | 1.70839 | [0.8794–3.319] | 0.114 | ||
Bone and Liver, and Lungs | 31 | 6.72 | 11 | [5–49] | 1.023939 | [0.6099–1.737] | 0.904 | ||
Bone and Lungs | 67 | 14.53 | 13 | [11–22] | 1.21943 | [0.8107–1.834] | 0.341 | ||
Liver | 8 | 1.74 | 3.5 | [1–NA] | 4.39485 | [1.9580–9.864] | 0.001 | *** | |
Liver and Lungs | 5 | 1.08 | 10 | [9–NA] | 1.90014 | [0.7503–4.812] | 0.176 | ||
Lungs | 9 | 1.95 | 8 | [3–NA] | 1.75303 | [0.7868–3.906] | 0.170 | ||
Time to Treatment | <1 month | 214 | 57.68 | 14 | [11–18] | reference | |||
1–18 month | 157 | 42.32 | 14 | [12–17] | 0.8217 | [0.6461–1.045] | 0.109 | ||
Treatment Summary | No treatment | 215 | 1.95 | 10 | [8–13] | reference | |||
Chemotherapy or Systemic Treatment | 32 | 6.94 | 19 | [16–33] | 0.7407 | [0.4890–1.1220] | 0.157 | ||
Radiation only | 141 | 30.59 | 11 | [8–15] | 0.8889 | [0.6974–1.1330] | 0.341 | ||
Radiation and Chemotherapy | 48 | 10.41 | 25 | [16–65] | 0.5427 | [0.3654–0.8061] | 0.002 | ** | |
Surgery only | 9 | 18 | [6–NA] | 0.7144 | [0.3344–1.5261] | 0.385 | |||
Surgery and Chemotherapy | 5 | 1.08 | 19 | [3–NA] | 0.8062 | [0.2987–2.1760] | 0.6707 | ||
Surgery and Radiation | 6 | 1.30 | 9 | [5–NA] | 1.5082 | [0.6663–3.4139] | 0.3242 | ||
All Three | 5 | 1.08 | 13 | [5–NA] | 1.3411 | [0.4965–3.6225] | 0.5626 | ||
Surgery to Non-Primary Site | No/unknown/other | 392 | 85.03 | 12 | [10–14] | reference | |||
Distant Site | 67 | 14.53 | 21 | [10–33] | 0.7486 | [0.5528–1.014] | 0.061 | ||
Lymph Node | 2 | 0.43 | 0.5 | [0.5–NA] | 2.0611 | [0.2884–14.732] | 0.471 | ||
Surgery to Brain Metastasis | No | 443 | 96.10 | 13 | [11–15] | reference | |||
Yes | 18 | 3.90 | 7.5 | [2–NA] | 1.1459 | [0.671–1.957] | 0.618 |
Category | Subcategory | Resection (n = 18) | No Resection (n = 443) | p | Sig |
---|---|---|---|---|---|
Age | 68.33 ± 6.65 | 70.02 ± 10.78 | 0.3175 | ||
Race | 0.3914 | ||||
White | 15 (83%) | 280 (63%) | |||
Hispanic | 0 (0%) | 63 (14%) | |||
American Indian/Alaska Native | 0 (0%) | 3 (0.6%) | |||
Asian or Pacific Islander | 1 (6%) | 23 (5%) | |||
Black | 2 (11%) | 74 (17%) | |||
Additional Metastases | <0.001 | *** | |||
None | 14 (78%) | 51 (12%) | |||
Bone | 0 (0%) | 261 (59%) | |||
Bone + Liver | 0 (0%) | 14 (3%) | |||
Bone + Liver + Lungs | 0 (0%) | 31 (7%) | |||
Bone + Lungs | 0 (0%) | 67 (15%) | |||
Liver | 2 (11%) | 7 (2%) | |||
Liver + Lungs | 0 (0%) | 4 (1%) | |||
Lung | 2 (11%) | 8 (2%) | |||
Survival | 16.00 ± 21.36 | 17.58 ± 22.04 | 0.7621 |
Category | Subcategory | Multivariable | |||
---|---|---|---|---|---|
HR | [95% CI] | p | Sig | ||
Race | Non-Hispanic White | reference | |||
Hispanic (all races) | 0.4126 | [0.2216–0.7680] | 0.0052 | ** | |
Non-Hispanic American Indian/Alaska Native | 0.4956 | [0.1172–2.0960] | 0.3400 | ||
Non-Hispanic Asian or Pacific Islander | 1.7181 | [0.8707–3.3904] | 0.1186 | ||
Non-Hispanic Black | 0.7364 | [0.4721–1.1485] | 0.1772 | ||
Tumor Size (cm) | <3 | reference | |||
>3 | 13.5045 | [1.6672–109.3849] | 0.0147 | * | |
Additional Metastases | None | reference | |||
Bone | 1.2316 | [0.7508–2.0202] | 0.4094 | ||
Bone and Liver | 1.7555 | [0.6909–4.4609] | 0.2369 | ||
Bone and Liver and Lungs | 1.0037 | [0.4322–2.3311] | 0.9931 | ||
Bone and Lungs | 1.0873 | [0.5749–2.0564] | 0.7968 | ||
Liver | 6.3700 | [2.2858–17.7522] | 0.0004 | *** | |
Liver and Lungs | 2.2564 | [0.5131–9.9225] | 0.2815 | ||
Lungs | 1.5616 | [0.5998–4.0660] | 0.3613 | ||
Treatment Summary | No treatment | reference | |||
Chemotherapy or Systemic Treatment Only | 0.4883 | [0.2477–0.9627] | 0.0385 | * | |
Radiation Only | 0.6775 | [0.4579–1.0024] | 0.0514 | ||
Radiation and Chemotherapy | 0.3946 | [0.2220–0.7014] | 0.0015 | ** | |
Surgery Only | 1.2845 | [0.4453–3.7057] | 0.6432 | ||
Surgery and Chemotherapy | 0.3267 | [0.0776–1.3751] | 0.1271 | ||
Surgery and Radiation | 1.2557 | [0.3678–4.2866] | 0.7163 | ||
All Three | 0.8085 | [0.2501–2.6143] | 0.7226 |
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Ladner, L.R.; Adhikari, S.; Bhutada, A.S.; Cuoco, J.A.; Patel, V.M.; Entwistle, J.J.; Rogers, C.M.; Marvin, E.A. Traditional Prostate Cancer Risk Assessment Scales Do Not Predict Outcomes from Brain Metastases: A Population-Based Predictive Nomogram. Cancers 2024, 16, 3029. https://doi.org/10.3390/cancers16173029
Ladner LR, Adhikari S, Bhutada AS, Cuoco JA, Patel VM, Entwistle JJ, Rogers CM, Marvin EA. Traditional Prostate Cancer Risk Assessment Scales Do Not Predict Outcomes from Brain Metastases: A Population-Based Predictive Nomogram. Cancers. 2024; 16(17):3029. https://doi.org/10.3390/cancers16173029
Chicago/Turabian StyleLadner, Liliana R., Srijan Adhikari, Abhishek S. Bhutada, Joshua A. Cuoco, Vaibhav M. Patel, John J. Entwistle, Cara M. Rogers, and Eric A. Marvin. 2024. "Traditional Prostate Cancer Risk Assessment Scales Do Not Predict Outcomes from Brain Metastases: A Population-Based Predictive Nomogram" Cancers 16, no. 17: 3029. https://doi.org/10.3390/cancers16173029