648 TUMOR GRADE IMPROVES THE ABILITY OF THE PROGNOSTIC ABILITY OF AJCC STAGES IN PATIENTS WITH PENILE CARCINOMA
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Résumé
You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease II1 Apr 2010648 TUMOR GRADE IMPROVES THE ABILITY OF THE PROGNOSTIC ABILITY OF AJCC STAGES IN PATIENTS WITH PENILE CARCINOMA Rodolphe Thuret, Claudio Jeldres, Lars Budäus, Giovanni Lughezzani, Daniel Liberman, Maxine Sun, Jean-Jacques Patard, Sharokh F. Shariat, Markus Graefen, Francesco Montorsi, Paul Perrotte, and Pierre Karakiewicz Rodolphe ThuretRodolphe Thuret Montpellier, France, Metropolitan More articles by this author , Claudio JeldresClaudio Jeldres Montreal, Canada More articles by this author , Lars BudäusLars Budäus Hamburg, Germany More articles by this author , Giovanni LughezzaniGiovanni Lughezzani Milano, Italy More articles by this author , Daniel LibermanDaniel Liberman Montreal, Canada More articles by this author , Maxine SunMaxine Sun Montreal, Canada More articles by this author , Jean-Jacques PatardJean-Jacques Patard Rennes, France, Metropolitan More articles by this author , Sharokh F. ShariatSharokh F. Shariat Montreal, Canada More articles by this author , Markus GraefenMarkus Graefen Hamburg, Germany More articles by this author , Francesco MontorsiFrancesco Montorsi Milano, Italy More articles by this author , Paul PerrottePaul Perrotte Montreal, Canada More articles by this author , and Pierre KarakiewiczPierre Karakiewicz Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1022AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The AJCC or TNM staging of penile carcinoma represents a standard and is widely used in clinical practice. We examined the ability of tumor grade that currently is not considered in the AJCC or TNM staging, to improve the prognostic ability of these two established staging schemes. METHODS We relied on a population of 1577 penile carcinoma patients stages T1-4 N0-3 M0 who underwent an excision biopsy or partial or radical penectomy with or without a lymph node dissection. Separated Cox regression models were fitted for AJCC stages I to III (stage 0 not considered), T and N stages, as well as for T and N stages with tumor grade (grades I vs. II vs. III-IV). Harrell's concordance index was quantified for each of the three tested schemes. RESULTS Overall, 194 patients died of penile carcinomas and the 5-year cancer-specific mortality rate was 16.1% (95% CI=14.0 to 18.4%). The accuracy of AJCC staging in the prediction of cancer-specific mortality-free survival was 68.3% versus 70.0% for TN-based prediction (Mantel-Haenszel test, p<0.001) versus 72.0% for T and N and grade-based prediction (Mantel-Haenszel test, p<0.001). CONCLUSIONS The AJCC staging stratifies non-metastatic penile cancer patients into three distinct categories versus 16 categories for the combination of T1-4 and N0-3 stages versus 48 categories for the combination of T1-4, N0-3 and Grade 1-3 stage and grade combination. The prognostic accuracy of the AJCC staging schemes was the lowest versus an intermediate value for the TN-based scheme versus the highest for the TN and grade-based scheme. The superior prognostic ability of the TN and grade-based scheme suggests that grade should be routinely considered when the T and N stages are used for prediction of prognosis. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e254 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rodolphe Thuret Montpellier, France, Metropolitan More articles by this author Claudio Jeldres Montreal, Canada More articles by this author Lars Budäus Hamburg, Germany More articles by this author Giovanni Lughezzani Milano, Italy More articles by this author Daniel Liberman Montreal, Canada More articles by this author Maxine Sun Montreal, Canada More articles by this author Jean-Jacques Patard Rennes, France, Metropolitan More articles by this author Sharokh F. Shariat Montreal, Canada More articles by this author Markus Graefen Hamburg, Germany More articles by this author Francesco Montorsi Milano, Italy More articles by this author Paul Perrotte Montreal, Canada More articles by this author Pierre Karakiewicz Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,010 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».